Parking Violation Request
Form
Attention Communications
Unit
Requested
By:___________________________________________
Today’s
Date:___________________________________________
Make:______________________________________
Model:_____________________________________
Body
Style:__________________________________
License
Plate Number:__________________________
State
& Expiration Year:________________________
o Abandoned / Not Driven o Expired License Plates
o No License Plates o Disrepair
o Parked In A Fire Lane o Parked In A No Parking Zone
o Parked In A Handicap Space o
Double Parked
o Blocking Traffic o Flat
Tire
o Fluid Leak o Eye
Sore
o Parked In A Paid Space Without Authorization
o Other Please Specify: ________________________________________
Please fill in as much information as possible. All of the requested information does not need to be filled out for a violation to be issued.
When completed please fax to Metropolitan Patrol (816)842-4441.
Any questions please feel free to contact Administration.
Received
By:_____________________________________________________ Date:______________
District
Officer:___________________________________________________
Stickered On:_______________ By
Unit:______________
Tow Date:_________________ Towed
By:____________