ATTACHMENT CV-5041

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar No., and Address):

TELEPHONE NUMBER:

FOR COURT USE ONLY

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FAX NUMBER:

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA

STREET ADDRESS:
CITY AND ZIP CODE:
PHONE NUMBER:

191 North First Street

San Jos, California 95113
(408) 882-2100

BRANCH NAME:

Downtown Courthouse, Civil Division

OFFICE HOURS:

Monday Friday 8:30 a.m. 4:00 p.m.

PLAINTIFF (Processing Agency):

DEFENDANT (Appellant):

CASE NUMBER:

NOTICE OF PARKING/ADMINISTRATIVE APPEAL

This is a Notice of Appeal of the decision of the hearing officer in the matter of parking
.
citation number
This appeal is filed pursuant to California Vehicle Code (CVC) 40230.
Appellant attaches a copy of the hearing officers decision and requests that:
1.

The Clerk of the Court set the matter for hearing before the above-entitled court, where it
will be heard in accordance with CVC 40230 and CVC 40215.

2.

The Clerk of the Court gives notice of the time and place of the trial to each of the parties.

Appellant certifies that a copy of this Notice of Parking/Administrative Appeal has been mailed
to the Processing Agency at the address shown below:

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF APPELLANT)

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CV-5041 8/01/05

NOTICE OF PARKING/ADMINISTRATIVE APPEAL

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