Type Full Name :
Sign With Hand
License Plate #*
Failure to park head on (1st offense)
March 31st
The parking permit that you will be issued is a permanent sticker for the outside of your vehicle. As of April 1, 2016 Your Town no longer sells transferable decals. If you need to use a different vehicle temporarily you must call the police department before parking your vehicle in the lot without a sticker. If you do not notify the police department you will receive a summons for parking without a permit. Non-residents are only permitted to purchase one parking permit.
All permit holders must park HEAD-ON within the lines of a designated parking space.
Non-Residents of Your Town
September 1st
Not parked in a space (train station lots)
January 1st
(1 Month)
This application is for a single vehicle only,
December 1st
By signing below, I certify that I have read and understood the rules and regulations pertaining to the issuance of a parking permit. I understand that this permit may be used for parking at the Your Town Train Lot ONLY. Non-residents are not permitted to park at the Your Town Blue Lot and will receive a summons and may be towed from the parking lot if parked at the Your Town Blue Lot.
(5 Months)
May 1st
Applicant's Details
February 1st
March 31st
(7 Months)
(555) 555-5555
Permits are issued on an annual basis only. All permits expire on March 31st of the year.
March 31st
Part I
(pertaining to parking at or near train station lots)
The Local Supplemental Violations Bureau Schedules that were prepared, pursuant to R 7:12-4, for offenses committed prior to the effective date of this schedule are on file with the municipal court administrator and are available for public inspection upon request.
March 31st
March 31st
March 31st
Permit fees are prorated automatically from the date of application to begin the following till March 31st.
November 1st
Violation Information
Ordinance #
(8 Months)
June 1st
The permit sticker must be displayed on the outside of the vehicle, on the bottom left side of the rear windshield.
* Indicates required field
Model/Body Style*
(9 Months)
March 31st
Payable Amount
(11 Months)
123 Main Ave
Vehicle Details
Non-Resident Parking Permit Application
(10 Months)
Last Name*
Pursuant to R 7:12-4, the following Local Supplemental Violations Bureau Schedule of designated offenses and Payable Amounts have been approved by the Vicinage Assignment Judge and shall be in effect for offenses committed on or after September 1, 2011. This Schedule shall be prominently posted for public inspection at the location of the Violations Bureau.
No parking permit (subsequent offense)
August 1st
Permits run by fiscal year from April 1st to March 31st.
Unit #
Your Town, USA 00000
Your Town
Failure to park head on (subsequent offense)
Refund Policy: $100 per each remaining full month, less a $10 administrative fee. Refunds will only be granted if the permit holder requests the refund before the start of a month. Permit holder must make request in writing and return the permit sticker with the request.
March 1st
Thank you for your cooperation.
Fee Schedule
Clear leaves, snow and debris from rear window so the permit is clearly visible. Your Town Ordinance states (in part) “…parking permit must be kept visible at all times while parked in the municipal public parking lot”.
(3 Months)
March 31st
April 1st
There is a $10.00 replacement fee for lost permits. You must provide proof of why the permit was lost such as a proof of sale for the old vehicle; if this documentation is not provided you will be subject to paying the full amount for a new permit.
(4 Months)
Fee Due
Below is the schedule of how the fees are prorated.
October 1st
Instructions for Parking Permit Holders
Designated Offenses
March 31st
Traffic Section [excerpt]
(6 Months)
March 31st
No parking certain hours
Parking is permitted between the hours of 5:00 a.m. and 2:00 a.m. Cars may not be parked overnight. If you are unexpectedly detained past 2:00 a.m., you must call the Police Department (555) 555-5555.
Short Description
July 1st
March 31st
If you have any questions or need additional information, please call the Your Town Clerk’s office (555) 555-5555.
Meter violation
First Name*
March 31st
No parking permit (1st offense)
(2 Months)
It is the permit holder’s responsibility to renew parking permits on time. All parking permits expire on March 31st. Please allow sufficient time to receive your permit in the mail.
Telephone #*
Meter violation (subsequent offense)