Administrative Citation Hearing Request Form

2. Only the person(s) listed on the Administrative Citation may request a hearing. If the cited party wishes a tenant, relative, or other designated proxy to attend the hearing, they must list that person(s) under "Person Attending Hearing"

4. Citation issued to:*

5. Phone Number*

7. Citation Number(s):*

8. Citation Date(s):*

10. Violation Address*

12. Person Attending Hearing*

13. Phone Number*

15. Reason for believing the citation(s) was issued in error:*

17. Ackowledgement*

    By typing your name above you declare under penalty and perjury that you are the cited individual and the foregoing statement and information provided are true and correct.

18. Date*

20. PAYMENT INFORMATION FOR HEARING ONLY

    1) An advance deposit of the full citation amount must be received within 30 days of the date of service of the citation.

    1) An advance deposit of the full citation amount must be received within 30 days of the date of service of the citation.

22. 2) If you are contesting the citation and are unable to pay the advance deposit, you may request an advance deposit hardship waiver within 15 days of the date of service of the citation. Complete the Request for Advance Deposit Hardship Waiver Form once you have reviewed the qualifications attached to the Waiver Form. Any form submitted without all of the proper documentation will be denied.

    2) If you are contesting the citation and are unable to pay the advance deposit, you may request an advance deposit hardship waiver within 15 days of the date of service of the citation. Complete the Request for Advance Deposit Hardship Waiver Form once you have reviewed the qualifications attached to the Waiver Form. Any form submitted without all of the proper documentation will be denied.

24. Contact Information

    City of Morgan Hill Finance Department (408) 779-7237; 17575 Peak Avenue Morgan Hill, CA 95037

    City of Morgan Hill Finance Department (408) 779-7237; 17575 Peak Avenue Morgan Hill, CA 95037

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

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