HIGHWAY SAFETY COMMISSION

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File for an Appeal Online

Appeal Form

Date of Appeal:
Full Name: *
Street Address or P.O. Box:
City:
State:
Zip:
E-Mail Address: *
Daytime Phone Number:
What are you appealing?
Appeal Description: (In plain language and detail, include sufficient facts and reasons upon which your appeal is based.)
Note: To expedite your appeal, include any correspondence you may have received concerning the denial that you are appealing. To help us serve you better, please provide your e-mail address. * Required Field

RELATED LINKS

LA County Home

LA County Code

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