Appeal a Parking Ticket

This is an Administrative Review Process. Please complete this form if you believe the parking ticket received by you is unwarranted because the facts alleged on the ticket fail to show an ordinance was violated or the parking meter was inoperable and you reported it within 24 hours after issue of the ticket. An Administrative Review Panel will consider the matter and make a determination on the merits of your case. Be complete, and include any documentation and/or diagrams, as this is the only evidence that will be considered by the review panel. A copy of the panel's decision will be mailed to you.

This form must be submitted within seven business days after issue date of ticket

If you do not receive a response within 30 days, contact the City Clerk's Office at (515) 283-4125

Questions? Contact the City Clerk's Office
400 Robert D Ray Drive, Des Moines, IA 50309-1891 (515) 283-4125

General Information



City or Town:

State or Province:

Zip or Postal Code:

Daytime Phone:


Citation Information
* Driver's License Number:

* Ticket Number:

* Date Ticket Issued:

* Violation Type

Vehicle Information
* Vehicle License Number:

* Vehicle Description:

Handicap Permit Number:

* Are you the vehicle owner

Appeal Information
* Reason for Appeal:


* Signature:

If you receive a "not voided" decision, the matter may be appealed to Polk County Associate District Court for judicial determination. If you request judicial determination, you must notify the City Clerk's Office in person within seven business days of the date of the response, that you wish the complaint be filed immediately, and you must sign a promise to appear.

Caution: Any statement made on this form may constitute an admission on your part.