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Known User Statement
Unknown User Statement
Submit an internal review
Use this form if you wish to request an internal review of your infringement.
You confirm you are the registered owner with VicRoads or the owner of the vehicle has completed a known user statement nominating you as driver of the vehicle for this infringement.
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.
Is this vehicle registered in a company name?
The name of the company that owns the vehicle.
Position at company
Your position at the company that owns the vehicle.
Select your Address
I will add the address manually
This is your residential postal address, including any room number if applicable. This is not the address of the offence.
Please enter the infringement number as it appears on the ticket/notice
including any leading letters
. Only alphanumeric characters are allowed.
This is the name of the Council/Hospital/University that issued the infringement. This is never Bartels, Taylor & Associates.
Vehicle Registration Number
Your email address
Grounds for Internal Review
- Select a value -
Contrary to Law
Mistake of Identity
We strongly urge you to visit the Reviews page before submitting your application to ensure you are lodging your submission under the correct ground for internal review. Be advised that if your submission does not meet one of the accepted grounds for internal review then your submission may not be accepted.
BTA Staff cannot offer legal advice.
Reason for internal review
Please provide a detailed statement above outlining why you believe your infringement has been issued incorrectly. You may attach any supporting evidence below.
Supporting Evidence and other attachments
Add a new file
Unlimited number of files can be uploaded to this field.
15 MB limit.
Allowed types: jpg png pdf doc.