CITATION DISPOSITION FORM

COMPLETE THIS FORM AND SUBMIT WITH A $622.81 CHECK

MAIL BOTH TO:

Department of Parking and Traffic (DPT)

Traffic Engineering Division – 194.3 Traffic Code citation
One South Van Ness Avenue, 7th Floor
San Francisco, CA 94103-5417

CHECK 5 ONE OF THE FOLLOWING OPTIONS

PAY CITATION – CASE CLOSED PAY CITATION & REQUEST HEARING

I understand and agree to the following:

I understand and agree to the following: 1. $622.81 enclosed as a deposit; then bring two checks to
the Protest Hearing.
2. I will be contacted by CaCDS to schedule the Protest
1. $622.81 is enclosed for full payment of the citation.
Hearing.
2. I do not wish to schedule a hearing for this matter.
3. Hearings are held at 502 7th Street (at Bryant St)
3. Once my payment is received by DPT, this citation will
4. Failure to appear at the Protest Hearing with CaCDS
be closed.
within 30 days of the date of citation will result in
4. This will NOT affect my Driver’s License, nor be
forfeiture of your enclosed $622.81 deposit and the case
recorded with the Department of Motor Vehicles (DMV).
will be closed.
5. This citation will be tracked for multiple violations within
5. This citation will be tracked for multiple violations within
a one year period per 194.3 San Francisco Traffic Code.
a one year period per 194 San Francisco Traffic Code.

Print Print

Signature Signature

Date Date

Citation Number: Contractor’s License #:

Name of Cited Person: __________________ Business Phone: ( )
Business Name: _____ Fax Number: ( ) _____________________
Managing Officer (RMO):
Email: ______________________________

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One South Van Ness Avenue • 7 Floor • San Francisco, CA 94103-5417 • Tel: 415.701-4500 • Fax: 415.701-4737 • www.sfmta.org/dpt