Date:
mm/dd/yy
1. Excess Charge Number
(this should commence: EL or SO):
2. Offence committed: (please tick the appropriate box)
Vehicle parked in a disabled bay without a valid disabled badge on display
Vehicle parked in a disabled bay without a valid disabled time clock on display
Parked for longer than the maximum period permitted
Parked for longer than the maximum period permitted in a disabled bay
Parked for longer than the maximum free period permitted
Vehicle not parked wholly within a single marked parking bay
Vehicle not of specified class and or not in a specified position Location of offence: (was seen at: name of car park)
3. Your Details
Full Name: Contact Address:
Postcode: Contact telephone number: Mobile telephone number: Email address:
4. Drivers Details
Drivers Name: (only provide if this is different to the above) Driver's contact address:
5. Vehicle details
Registration Details: Make of Vehicle::
6. Other relevant information
If you have a valid ticket please use the download version of this form (linked below), print off the form, and send it together with the valid ticket or clear photocopy of the ticket to East Lindsey District Council, Car Parking Section, Town Hall, North Parade, Skegness, Lincolnshire PE25 1DA
Permits include weekly / monthly / quarterly / annual / seasonal or staff Permits The permit number is:
If you have a valid blue badge please use the download version of this form (linked below), print off the form and send it, together with a clear photocopy of both the front and back of the blue badge to East Lindsey District Council, Car Parking Section, North Parade, Skegness, Lincolnshire, PE25 1DA
7. Brief description / Extenuating cirumstances