Citation Number:

I want to appeal a Texas A&M International University Traffic Citation, as numbered above.

The reason(s) I want to appeal is (are) as follows:

Name:

Universal ID Number:

E-Mail:

License Plate Number: State:

Location of Violation

Date of Violation

Have you previously received other citations, if yes, how many?

(Those without E-mail can use the address option.)

Address:

Phone #: - - (Optional)