The University of Memphis
Visitors Appeals Form
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Name: Date:


Address:    -
                    Street or Box/City/State/Zip

Telephone #: - -

Citation #:     License Plate #:

Reason for Appeal:

For Office Use Only

Verified by: ______________________________________________________

Disposition: Upheld Denied Reduced      Amount Reduced $ _________________


Signature: _________________________________

The University of Memphis is an Equal Opportunity/Affirmative Action University.
It is committed to education of non-racially identifiable student body.