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Bylaw notice dispute form

To dispute a Bylaw Notice (ticket), this form must be submitted to the Township of Langley Bylaw Enforcement department within 14 days from the date of issuance.

Bylaw Notice Number

Date of Offence

Vehicle Licence Plate Number

Disputant’s name

Disputant’s Mailing Address

Postal Code

Daytime Phone Number

Email (enables us to send any applicable evidence to you)

Reason for Dispute (must contain defence of the allegation)

Notes:

A $25 fee is added to the total fine if the adjudicator finds that the offence did occur.
The adjudicator does not have the authority to modify the offence or penalty.
Overdue penalties and fees may be forwarded to a collection agency and/or court action taken.

^{Any personal information collected on this form will be managed in accordance with the Freedom of Information and Protection of Privacy Act. Direct enquiries, questions, or concerns regarding the collection, use, disclosure, or safeguarding of personal information associated with this form to: Supervisor, Information, Privacy, and Records Management, Township of Langley, 20338 – 65 Avenue, Langley, BC V2Y 3J1 foi@tol.ca 604.532.7396}