Form Center

2. 
3. This form is used to request an appeal hearing on the issuance of the City of North Miami violation ticket. Please take note that if the City prevails at the appeal hearing, then in addition to the ticket fine amount, the property owner shall be charged an additional $100.00 for the cost of court case prosecution. Please print information requested below, and return the completed form to the Code Compliance office.
5. Civil Violation Ticket Number:
6. Ticket Date of Issuance:
   Ticket Date of Issuance:
8. Property Address of Violation:
10. City
11. State
12. Zip Code
14. Phone Number
15. Property Owner’s Name:
17. I swear or affirm that I am the property owner of the above noted property address, or that I have power of attorney to represent the property owner in this matter, and I hereby request an appeal hearing on the issuance of the civil violation ticket noted above.
19. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
21. Electronic Signature
23. Print Name
24. Date
    Date
28. Change of Mailing Address
    Please complete this section if the mailing address for the above property is different from that written on the civil violation ticket.
30. Mailing Address
32. City
33. State
34. Zip Code
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit Submit and Print

* indicates a required field