Screening Request Form

You have 15 days from the date of the penalty notice to request a screening. The screening decision will result in either ticket payment, adjustment, or cancellation. For more details about the screening process please visit the AMPS page.

Penalty Notice Recipient


Penalty Notice Information

Please provide the information found on the Penalty Notice
One file only.
64 MB limit.
Allowed types: gif, jpg, jpeg, png, txt, rtf, pdf, doc, docx, ppt, pptx, xls, xlsx, mov, mp3.


Type of Screening Requested
Note: a written screening allows processing without your attendance at Town Hall.

Screenings are held every Thursday (duration of approx. 15 minutes) between 1 p.m. and 4:15 p.m. Screenings will be scheduled for the next available Thursday. 

In-person screening appointments must occur on the date specified unless prior notice is given. Failure to attend a scheduled screening appointment will result in a non-appearance fee of $50 being added to the penalty notice fine amount.

I accept and acknowledge the following:

  • am the registered owner of the vehicle or I am acting on behalf of the registered owner of the vehicle
  • I am the person named on the penalty notice
  • I acknowledge that if I fail to appear and/or fail to remain at my scheduled in-person screening until my matter has been determined by the screening officer, the administrative penalty will be affirmed, and I will be liable for an additional fee for having failed to appear
  • I have read and understand the conditions of this application 
I accept and acknowledge the following: