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2. First Name*
3. Last Name*
4. Email*
6. Violation Address*
8. Description of Violation*
10. Photo of Vehicle*

    Please upload a photo of the vehicle clearly showing the violation.

11. Photo of License Plate*

    Please upload a clear photo of the vehicle license plate.

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13. 1. Receive an email copy of this form.
14. Email address

    This field is not part of the form submission.

15. Submit

* indicates a required field