Rocklin, CA · Placer County
Appeal Hearing Request – Administrative Citation
People cited for a Rocklin administrative citation use this form to request a hearing and explain why they believe the citation was issued in error.
What this form is
This form lets a person cited for a Rocklin administrative citation request a hearing by mail or before a hearing officer and explain why they believe the citation was issued in error. The request must be filed within 30 days of the citation date with a copy of the citation and the advanced deposit of the fine. The form also includes an optional hardship waiver request requiring an explanation and income documentation.
Who needs it
A person named on a Rocklin administrative citation who wants to contest it or request an advance deposit hardship waiver should complete this form.
How to submit it
File the request with the City Clerk’s Office at 3970 Rocklin Road, Rocklin, California 95677, within 30 days of the citation date. Attach a copy of the citation and pay the advanced fine deposit by check; checks only are accepted.
About notarization
This request is signed and dated without a notary; the signer declares the statements true under penalty of perjury, and hardship requests require income documentation.
How to submit this form
- 1
Download the Request
Download the Administrative Citation Hearing Request form.
- 2
Complete the Form
Choose a hearing option, provide citation and contact details, explain why you believe the citation was issued in error, and sign and date the request.
- 3
Gather Attachments
Attach a copy of the citation and include the advanced deposit of the fine by check. For a hardship waiver, include an explanation and income documentation.
- 4
Submit to the City Clerk
File the request with the City Clerk’s Office within 30 days of the citation date at 3970 Rocklin Road, Rocklin, California 95677.
Frequently asked questions
- Do I need a notary for the Administrative Citation Hearing Request?
- No. The form has signature and date fields but no notary block. The signer declares the information true under penalty of perjury; a hardship waiver request also requires income documentation.
- How do I submit the hearing request?
- File it with the City Clerk’s Office at 3970 Rocklin Road, Rocklin, California 95677, within 30 days of the citation date. Attach a copy of the citation and include the advanced deposit by check.
- What information does the form ask for?
- It asks for citation and contact details, the violation address, the person attending the hearing, and an explanation of why the citation was issued in error. It also offers hearing-by-mail and hearing-officer options.
- What is needed for an advance deposit hardship waiver?
- The person listed on the citation must file the waiver request with the City Clerk within 30 days of the citation date, explain financial inability to deposit the full fine, and provide documentation verifying current income sources.