396 JEFFERSON AVENUE BOH TICKET VIOLATION #E101 CITY OF SALEM NOTICE OF VIOLATION
OF CITY ORDINANCE,RULE,OR REGULATION
DATE OF NOTICE NOTICE NO.
/.�� E101
NAME OF OFFENDER
ADDRESS OF OFFENDER
CITY,STATE,ZIP CODE DOB OF OFFENDER
PARCEL ID NUMBER
OFFENSE(s)
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DATE TfI�1EO2 2.-5,Ny
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LOCATION OF VIOLATION__
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AME OR ID NUMBER OF ENFORCING PERSON ENFORCING DEPT.
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I HEREBY ACKNOWLEDGE RECEIPT OF THE FOREGOING CITATION
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Q Unable to obtain signature of offender. Date Mailed
THE NONCRIMINAL FINE FOR THIS OFFENSE IS$ A> `
YOU HAVE THE FOLLOWING ALTERNATIVES IN THIS MATTER:
Options(1),(2)or(3)will operate as a final disposition.with no resulting criminal record.
(1) You may pay the above noncriminal fine,either by appearing in person or
through an authorized agent,or by mailing a check,money orderor postal note WITHIN 21 DAYS OF
THE DATE OF THIS NOTICE to:City of Salem.Collector's Office,93 Washington Street.Salem.MA
01970.
(2) You may contest this matter by making a written request for a noncriminal hearing
before a municipal hearing officer WITHIN 21 DAYS OF THE DATE OF THIS NOTICE to: City of
Salem.Legal Dept.Attn:Hearing Officer,93 Washington Street,Salem,MA 01970.If that decision is
adverse to you,within 10 days you may request a new hearing before a court magistrate.
(3) You may obtain a review and disposition by mail by mailing your request WITHIN 21
DAYS OF THE DATE OF THIS NOTICE to the address shown in Option(2)above. If the disposition
by mail is adverse to you,you may subsequently request a noncriminal hearing before a municipal
hearing officer.
(4)If you do not pay the noncriminal fine or request a hearing or a review by mail within 21
days,or if you do not appear for the hearing or pay any fine determined to be due,a criminal
complaint may be issued against you.
❑ I elect Option(1)above,confess the violation charged,and enclose payment by
check,money order or postal note in the amount of$ .1 have written
the number of this notice on my check,money order or postal note,or enclosed a copy
of this notice.
❑ 1 elect Option(2)above and request a noncriminal hearing on this matter. 1 have
enclosed a copy of this notice and my name and current address.
❑ 1 elect Option(3)above and request a review and disposition by mail. 1 have
enclosed a copy of this notice,along with a signed statement of my objections,and
signed statements from other relevant persons and any other materials 1 wish to have
considered./have marked all statements and materials with my name and address.the
number of this notice,and the violation date.
Signature