Statutory declaration (Vehicle emissions) - Unpaid penalty charge
| Published date | 21 March 2018 |
Statutory Declaration – unpaid penalty chargeForm PE3
(Vehicle Emissions)
Traffic Enforcement Centre St Katharine’s House 21-27 St Katharine’s Street Northampton NN1 2LH | Penalty Charge Number | |
Vehicle Registration Number | ||
Applicant | ||
Location of Contravention | ||
Date of Contravention |
Give full details and tick the box which applies. You must ensure that all details above are correctly entered from the Order for Recovery of unpaid fixed penalty notice.
You must then have the form sworn before a Commissioner for Oaths (e.g. a Solicitor), a Justice of the Peace (at any Magistrates Court) or an officer of your local County Court hearing centre before sending the declaration to the Traffic Enforcement Centre at the above address. You may have to pay a fee.
I, (full name and address of the respondent including postcode), please complete this form in BLOCK CAPITALS and in black ink.
The above named respondent, declare that: (tick the box, which applies)
I did not receive the fixed penalty notice
I made a request for a variation of fixed penalty to the authority pursuant to Regulation 19 of the Road Traffic (Vehicle Emissions) (Fixed Penalty) (England) Regulations 2002, but did not receive notification that the amount of the fixed penalty had been reduced or (as the case may be) that my request had been refused nor of the amount that was payable
My reasons are (give full reasons)
Important: Filing a false declaration knowingly and wilfully is a criminal offence under ...
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