Dispute a Parking Infringement Form

Use this form to request a review of your infringement notice. Your request should be based on the grounds outlined on our Dispute a Parking Infringement page.

Please provide all relevant detail and any supporting information to help us assess your request. Fields marked * are required.

Section 1: Infringement Details

Infringement Number*
Vehicle Registration Number*
Location (if known)
Date of Infringement*
Please note that a dispute must be submitted before the Due Date of any infringement notice.

Section 2: Your Personal Details

Full Legal Name*
Preferred Name
Date of Birth*
Postal Address*
Email Address
Phone Number
Connection to vehicle* Please check all that apply.	I am the registered owner The registered owner is a company, I represent that company I was the driver at the time

Please note:

Vehicle owners are legally liable for stationary vehicle offences. If you wish to transfer the liability to a driver in charge at the time, please have that driver complete this form instead of yourself. The declaration below requires that the person resonsible for the parking be the person making the request. Requests can only be accepted from the registered owner, or the non-owner driver responsible.

Section 3: Reason for Review

Please explain why you dispute this infringement*:

Supporting file (1):
Please click Choose File to add one file that includes your supporting evidence. If further files are necessary, click this link to email parking@selwyn.govt.nz - please include the vehicle registration number in the subject line.

Section 4: Declarations

Both declarations are required in order to accept this request for review. *

I declare that the information provided in this request is true, complete, and accurate

I declare that I accept liability for the infringement notice submitted with this form

If you are not the vehicle owner or the driver responsible, please have the driver submit this review instead.

Section 5: Submit

Please check all information above. Additional files can be emailed, as above.

Privacy statement

The personal information you provide in this form will be collected, held and protected by Selwyn District Council in accordance with our Privacy Policy and the Privacy Act 2020. Our Privacy Policy explains how we use and share personal information in relation to any interaction you have with Council, and how you can access or correct your information at any time.

You can read the full policy at selwyn.govt.nz/privacy.

We will use the email address you provide to send communications directly related to this form or application. By submitting this form, you consent to receive those communications by email. If you require a hard copy, please email ContactUs@selwyn.govt.nz, visit our Service Desk Team or call 0800 SELWYN (735 996).