ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, address and telephone #): FOR COURT USE ONLY STATE BAR NO: ATTORNEY FOR (Name): MARIN COUNTY SUPERIOR COURT 3501 Civic Center Drive P.O. Box 4988 San Rafael, CA 94913-4988 APPELLANT: NAME: ADDRESS: CASE NUMBER: NOTICE OF APPEAL - PARKING As the appellant, I hereby appeal the final administrative decision on parking citation no. ________________ which was originally issued by ______________________________________ on __________________. The hearing was: Personal Conference Decision Rendered by Mail Date of mailing of final decision by issuing agency: _____________________________. MANDATORY REQUIREMENTS This Notice of Appeal must be filed within 30 days after personal delivery or within 35 days after mailing (Code of Civil Procedure § 1013) of the issuing agency's decision to the appellant; A filing fee of $25.00 is required at the time of filing; No later than 10 days prior to the de novo hearing (see date below), you must file proof of service with this court that the issuing agency was served with this Notice of Appeal; and Failure to comply with each of these requirements may result in the dismissal of your appeal or denial of a de novo hearing. I declare under penalty of perjury that the foregoing is true and correct. DATE APPELLANT'S SIGNATURE A hearing will be conducted at the Marin County Superior Court on _________________________________ at ______________________ AM / PM in courtroom ________. JAMES M. KIM Court Executive Officer Date: By: DEPUTY Upon receipt of this notice, the issuing agency shall be responsible for sending the complete file to the Marin County Superior Court within 15 days. CV029 NOTICE OF APPEAL - PARKING American LegalNet, Inc. www.FormsWorkFlow.com Rev. 8/3/15