Affidavit Of Non-Liability / Contested Notice Of Toll Evasion printable pdf download

Violation Processing Department

P.O. Box 26925, San Francisco, CA 94126

877-BAY-TOLL (877-229-8655)

Fax 415-956-1663

TDD/TTY 415-486-2492

*T1212015504*

TEV # T12120

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NOTICE DATE: 04/11/2013

AMOUNT DUE BEFORE 04/26/2013: $31.00

0000001-0000001 APPRT 001 ------ 021404

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AMOUNT DUE AFTER 04/26/2013: $76.00

SECOND NOTICE - DELINQUENT TOLL EVASION VIOLATION

UNPAID VIOLATIONS WILL BE SENT TO THE DMV

TO BE COLLECTED WITH YOUR DMV REGISTRATION RENEWAL

You will not be able to register your vehicle until outstanding tolls and penalties are paid.

This is the Second and Final notice for the violation(s) listed herein. You must pay the toll and penalties in full by the due date

to avoid additional penalties and fees and withholding of your DMV vehicle registration and/or referral to a collection agency

(California Vehicle Code 4770 and 40267). CVC Section 40258 allows a penalty assessment of up to $100 for the first violation,

$250 for the second violation within one year, and $500 for each additional violation within one year.

If you have already paid or responded to this notice, you can visit to check the status of the

violation(s).

To Contest the violation(s) or make a Claim of Non-Liability: Complete Section A or B on the reverse side of this document

and return within 30 days from the notice date.

ATTENTION FASTRAK AND LICENSE PLATE ACCOUNT HOLDERS

If you were a Bay Area FasTrak or License Plate account holder in good standing at the time of the violation(s), you received

this notice because the vehicle in violation was not listed on your account. You must respond to this notice by completing

Section C on the reverse side of this violation. Failure to respond to this notice within 30 days of the notice date will result in

additional penalties and fees and your DMV vehicle registration being withheld and/or referral to a collection agency.

Our records indicate that valid payment was not received for the vehicle crossings for the date(s), time(s) and location(s) shown

on page three of this notice. California Streets and Highway Code (Section 30843 et seq.) and the California Vehicle Code

(Section 23302 et seq.) require that tolls be paid and that penalties or fees may be charged if the proper toll is not paid.

YOU CAN PAY:

1. Online, by credit card, at .

2. By phone at 877-BAY-TOLL (877-229-8655).

3. By mail. Complete the payment form at the bottom of this notice and return it in the envelope

provided. If paying by check or money order, please write the TEV # (see above) on your payment.

DO NOT send cash.

4. At Walk-in Cash Payment Locations, by Cash only - Visit

to find a location.

A return check fee of $25.00 will be assessed for any returned check.

Failure to pay this notice in full by the due date will result in additional penalties and fees and referral of the

remaining amount due to a collections agency and/or withholding of your vehicle registration.

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Affidavit Of Non-Liability / Contested Notice Of Toll Evasion

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