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Request for Screening 

Pursuant to Section 13 of By-law 20-073, as amended, of the City of Peterborough. 

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 Section 13. 

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. 

Note:

The Request for Screening must be filed before 4:30 p.m. on the 21st day after Penalty Notice Date by the registered owner of the motor vehicle to which this Penalty Notice applies. If the Person who was given a Penalty Notice has a valid reason for missing that deadline, then the Person can complete the form called Request for Extension of Time for a Screening, and the Screening Officer will review your reason(s) and grant the extension or not.

If the Penalty Notice Date was more than 21-days before today’s date, you must complete the form entitled Request for Extension of Time for a Screening. If you complete the wrong form, the Administrative Penalty will be deemed to be affirmed.

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