Required fields are marked with asterisks (*)

Bylaw Violation Notice Payment Form

Please ensure all your information is current and correct prior to submitting this form.

Section 1: Contact Information

First Name

Last Name

Business Name (if Applicable)

Phone Number

E-Mail Address

Home Address

Section 2: Violation Notice Information

*Pleaes ensure all information matches information written on the notice

Bylaw Notice

*Please ensure your ticket is a City of Cold Lake Municipal Bylaw Violation Notice

Date of Offense

Violation ID number

Offense Description

Has it been more than 7 days since the notice was issued?

Yes

Upload copy of bylaw violation notice

To confirm the details of your violation notice, you can upload an image of the notice here.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATIA Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.