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.
Attachments
Unlimited number of files can be uploaded to this field.
2 MB limit.
Allowed types: jpg png pdf doc docx.
Acknowledgement

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.
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