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2. First and Last Name
4. Phone Number
6. Your Email Address
8. Address
10. City
11. State
12. Zip Code
14. Make and Model of Car
16. License Plate
18. Date Ticket Was Issued
    Date Ticket Was Issued
19. Location Where Vehicle Was Parked
21. Violation Number
22. Meter Number (If Any)
23. Ticket Number
25. Reason for Challenge
27. Submit Photo (If Any) in Reference to Challenge
    (2MB maximum size)
29. (2MB maximum size)
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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

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