ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): Telephone No.: Fax No. (Optional): E-Mail Address (Optional): ATTORNEY FOR (Name): Bar No: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER: 700 Civic Center Dr. West, Santa Ana, CA 92701-4045 APPELLANT: RESPONDENT: NOTICE OF APPEAL - PARKING CITATION CASE NUMBER: Parking violation fee † has been paid. † has been waived by the Parking Administration.

Contestant/Appellant, , of the above entitled action, having exhausted the administrative review process, hereby appeals to the Superior Court of California, County of Orange from the final decision of the administrative review, which was mailed on , regarding parking citation number: . I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME (SIGNATURE OF CONTESTANT/APELLANT OR ATTORNEY) NOTE: A separate appeal must be filed for each Noticeof Parking Citation or Notice of Delinquent Parking Violation.

A copy of this document must be mailed to the processing agency. The original appeal with proof of service must be filed with the Court with the proper filing fee. PROOF OF SERVICE BY MAIL I deposited a copy of this Notice of Appeal in the United States mail, in a sealed envelope with postage fully prepaid. The envelope was addressed as follows (name and address of processing agency): Date of mailing: Place of mailing (city and state): ________________________ I am a resident of or employed in the county where the Notice of Appeal was mailed. My residence or business address is: Street Address: City: State: .

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: (TYPE OR PRINT NAME) (SIGNATURE OF DECLARANT) Approved for Optional Use L-693 (Rev. July 2013) NOTICE OF APPEAL – PARKING CITATION Vehicle Code § 40230 www.occourts.org