Application for Withdrawal of Infringement Notice

Please note: A Statutory Declaration may be requested in addition to this form.

Applications can take up to 7 days for processing. Responses will be received via email/post advising you of the outcome.

Application for Withdrawal of Infringement Notice

Full name of the person submitting the declaration
Applicant details
Type of dispute

If you are at fault due to paying for a different number plate, your infringement will not be withdrawn. 

(attach any additional pages, photographs or documents as necessary)

One file only.
20 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, jpg, png, jpeg.
One file only.
20 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, jpg, png, jpeg.
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City of Darwin complies with Information Privacy Principles contained in the Northern Territory Information Act. These principles protect the privacy of personal information collected, used and stored. It also details how you can access your personal information. Council’s Privacy Statement is available from the City of Darwin, Harry Chan Avenue, Darwin or online.
I hereby

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