Instructions for Person completing this form
In Section 12 the “Person who is given the Penalty Notice”, means the registered owner(s) of the motor vehicle.
Please review By-law 20-073 and pay particular attention to Sections 13. The Request for Extension of Time for Screening must be filed before 4:30 p.m. on the 42nd day after Penalty Notice Date by the registered owner of the motor vehicle to which this Penalty Notice applies. If you are requesting a Screening before 4:30 p.m. on the 21st day after the Penalty Notice Date, please use this form Request for a Screening
If you do not attend and remain at the Screening at the scheduled time or pay the amount shown on the Penalty Notice, an administrative fee of $50 will be added to the amount of the Penalty Notice.
If you have any problems completing this form, please email AMPs@Peterborough.ca
Please double-check all information, including your contact information, to make sure that it is accurate and complete.