Appeal an Infringement

To successfully appeal your infringement, you will be required to submit evidence to prove that an Authorised Officer has made a mistake.

Infringements are designed to point out the seriousness of your failure to act responsibly. Whether you have been caught parking in an ACROD bay without the appropriate certification, or if your firebreaks have failed inspection, it is your civic duty to act more responsibly in future.

Before you submit your appeal, please first read the detail about common infringements in the Shire of Denmark available at the links below:

Firebreak and Fuel Management Notice Infringement FAQs Using Your ACROD Permit

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Start Your Appeal Application

Instructions

Please complete the following form with as many details as you can to help us process your request in a timely manner. Questions with an asterisk(*) are mandatory. Please note that we take your privacy seriously and will not disclose your details to any third party without prior permission.

Contact Details

Given Names*

Last Name*

Contact Phone Number*

Email Address:*

Residential Address*

Postal Address (if different from residential)*

What is your preferred method of receiving correspondence?*

EmailPostTelephone

Infringement Details

Infringement Number (required)*

Date of Infringement (required)*

To successfully appeal your infringement, you will be required to submit evidence to prove that an Authorised Officer has made a mistake. Please detail the evidence you have to support your appeal.*

Please upload your evidence (up to three files)*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

I certify that the information I have submitted in this form is true and correct to the best of my knowledge, I am aware that it is an offence to provide false and misleading information.*

AgreeDo not Agree

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Please note, after clicking 'submit form' below, you will receive a confirmation of submission message. If you do not receive this message, and you are returned to the top of this webpage, you have likely not answered all questions marked with an asterisk(*) and your appeal will not have been submitted. Please review your submission and make sure you have answered all the mandatory questions.

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