Form Builder

Required fields are marked with asterisks (*)

Request a screening review

 

Fill out this form if you would like to dispute your ticket through a screening review.

  • You can dispute your ticket within 30 days of receiving it.
  • After your screening review, you will receive the decision in-person, by email or mail. 

You can submit this request online or print it and mail it in. To print the form, right-click on the completed form and select print. Mail your printed request to:

Municipal Enforcement Services
1st Floor, Waterloo City Hall
100 Regina St. S.
Waterloo, ON
N2J 4A8


Request Support

Contact the city at 519-747-8785, TTY (for deaf) 1-866-786-3941 or amps@waterloo.ca if you have any questions or need:

  • accessibility accommodations
  • translation
  • financial support
  • help filling out the form or don't have reliable access to a computer or the internet

 

Is this screen review request for a parking ticket?
 
Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Screening reviews will be in English. Are you comfortable with English or do you need help with translation?
 
Declaration
 
Clear

To the extent that the following information constitutes personal information as defined in the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990, chapter M.56 as amended, the information is subject to provisions of that Act and will be used for the purposes indicated or implied by this form. Questions about the collection of personal information should be directed to the City Clerk, Waterloo City Centre, 100 Regina Street South, Waterloo, Ontario, N2J 4A8, telephone (519) 886-1550.