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Online Forms

Animal Infringement Appeal Application

Only one Internal Review may be submitted per infringement notice, unless applying when an Internal Review has been granted on the ground of Person Unaware of Fine.

Your Details

Postal Address

All responses will be posted to your mailing address as per Infringements Act 2006.

Infringement Details

Grounds for Appeal

Applicants please note:  If you do not provide sufficient information, the enforcement agency may request further information. If you do not provide this further information within the time specified, the enforcement agency may determine the application without further information.

Attach Supporting Documentation Limited to 30MB. Only image files, Microsoft Word Documents and PDFs are accepted.

Declaration

  • I understand that this is the only Internal Review for this infringement that I am able to submit pursuant to s.22(2) of the Infringements Act 2006.
  • I declare that the information I have supplied in this form, and any attachments to this form, are true and correct to the best of my knowledge.
  • I understand that by making a false or misleading statement in support of this claim, I may be prosecuted.

Collection Statement

Your personal information is being collected by City of Ballarat for the purpose of processing your application for an internal review of an animal infringement in accordance with the Infringements Act 2006. Your information will be stored in Council’s Customer Database and used to identify you when communicating with Council and for the delivery of services and information. For further information on how your personal information is handled, refer to Council’s Privacy Policy at www.ballarat.vic.gov.au/ac/privacy.aspx