CITY OF NEW CARROLLTON 6016 PRINCESS GARDEN PARKWAY - NEW CARROLLTON, MARYLAND 20784 (301 ) 459-3771 REQUEST FOR EXTENSION OF TIME FOR VEHICLE IN VIOLATION
Name
Case NO#
Address
Phone Number
Email
Make of Vehicle
Model
Year of Vehicle
Color(s)
Tag #
State
Expiration Date
No Visible Tag
Number of Days Requested for Extension (30 day Maximum)*
Location of the Vehicle: (Check One)
Drive Way Front Yard Other
Garage Backyard
If other, please indicate location.
Nature of Violation
Detailed Description for Request Extension
Have You Previously Requested an extension for this vehicle?
Have you requested an extension for any other vehicle?
Signature
Date
*(Please note this request to grant an extension may be declined or approved for less that the time requested.)