* Denotes that the field is mandatory.
In certain circumstances the City is prepared to assess an infringement once it has been issued. Together with suitable proof, the following situations will be considered for withdrawal, however this is not guaranteed.

Clearway Towing
Please note, if your vehicle has been towed, this is a separate matter to the infringement issued by the City of Perth.
Enquiries regarding the towing of your vehicle can be made by contacting Main Roads on 138 138, or email enquiries@mainroads.wa.gov.au


Please do not enter your credit card information in this form. If further information is required, an authorised City of Perth Officer will contact you.

Please complete all details in full.

Infringement number(s) *
Vehicle registration number *
Title
Given Names *
Surname *
Postal address *
Suburb *
State *
Postcode *
Phone Number
Mobile phone number
E-Mail Address *
Were you the driver of the vehicle
at the time of the infringement?
*
Are you the registered owner of
the vehicle?
*
Under Section 9.13 (6) of the Local Government Act 1995, the onus is on the registered owner of the vehicle to notify this office, in writing and provide the full name and address of the driver. Failure to do this deems the owner responsible for the infringement notice incurred.
Police reference number
For Royal Perth Hospital emergencies: Contact the Car Park Co-Ordinator, Security Unit, Royal Perth Hospital by telephoning (08) 9224 2202 and attach to this form the letter which the Car Park Co-ordinator provided.
Medical emergency at Hospital
Brief summary of appeal
State name of hospital letter attached
Hospital letter must be attached for this appeal to be considered, please see above for details on contacting the hospital
Attach Additional Information
Attach Additional Information
For other medical circumstances, please attach your medical certificate and supporting letter from your Specialist or Medical Practioner.
Brief summary containing key times and special circumstances which you would like to be considered
Type of supporting evidence provided
Evidence must be attached for this
appeal to be considered
Attach Additional Information
Attach Additional Information
For vehicle breakdowns where the RAC were called out, please simply attach your RAC call out confirmation letter to this form.
Alternatively, please attach all relevant receipts for car parts and towing as evidence towards your appeal.
Please note 'running out of fuel' will not be considered.
Brief summary containing key times
Summary containing time the vehicle was left, the nature
of the problem and why the car broke down, and the action taken
to rectify the problem and/or to remove the vehicle from the location
State type of evidence eg. RAC letter, car parts or towing receipt
Your RAC letter or receipts must be attached here in order for this appeal to be considered
Attach Additional Information
Attach Additional Information
Please check your infringement has been issued for ‘failed to display an unexpired ticket’ or ‘failed to display a ticket properly’. This can be found on your infringement notice. Only infringements issued for these reasons will be considered. A valid parking ticket must also be submitted.

Infringements issued for ‘stopping a vehicle longer than time allowed’ or ‘stopped during a restricted period’ are not ticket related infringements and will not be considered.
Type of ticket offence
Brief summary detailing where the valid parking ticket was situated in the car and the reason the ticket was not visible to the Parking Officer
Description of Evidence
Attach ticket here
Attach Additional Information
*Do not attach images of credit cards
Attach Additional Information
*Do not attach images of credit cards
Appeals may be considered for other reasons.
Details of the circumstances to be considered.
Supporting evidence or information
Attach supporting evidence here
*Do not attach images of credit cards
Attach Additional Information
*Do not attach images of credit cards
Attach Additional Information
*Do not attach images of credit cards