Payment Plan Request

Please separate infringement numbers with a comma. ie 12345,12346,12347...
This is the name of the Council/Hospital/University that issued the infringement. This is never Bartels, Taylor & Associates.
Please be advised that only the registered owner of a vehicle can request a review of an infringement. The owner must submit a Known User Statement nominating you as the driver of the vehicle or a letter of authorisation authorising you to represent them for this matter. If you have one of the requested documents from the owner, please attach it below.
Each Payment Plan is different. There are minimum instalment amounts required for payment plans where the owner does not have a valid concession card and also a maximum number of instalments allowed. A good guide is to keep the number of instalments under 15.
Unlimited number of files can be uploaded to this field.
2 MB limit.
Allowed types: jpg png pdf doc docx.

I understand and acknowledge that:

  • This document is a digitally signed statement.
  • It is an offence to provide false or misleading information and a penalty may be imposed under the relevant acts.