Name(Required)
Payment Notice Provide details of payment notice you are disputing
DD slash MM slash YYYY
Address(Required)
Have you previously lodged a complaint regarding this payment notice? Yes No(Required)
Complaint (Provide details of the complaint). Attach any applicable evidence via the upload.
Explain what you would like to see happen as a result of your complaint.
Consent(Required)
Please upload any supporting evidence to support your claim.
Max. file size: 15 MB.
Care Park Pty Ltd, GPO Box 3022, BRISBANE QLD 4001 Phone: 1300 760 544 paymentnotices.com.au © Care Park Pty Ltd 2009

WARNING

It is a criminal offence to provide a false declaration. Where Care Park has evidence that indicates the content of a statutory declaration is untrue, it is company policy to refer the matter to police for investigation and prosecution.

Payment Notice Dispute Guidelines

If a Payment Notice has been issued to you and you consider there is a basis upon which it should be reconsidered, you may apply to have it reviewed under Care Park’s disputes process. To facilitate a fair and speedy resolution of disputes, the following guidelines are applied:

Your application for Review must be in writing, preferably on this form. Care Park staff are are unable to initiate the review process by telephone.
You have 21 days from the date of issue of the Payment Notice (or from the date of Care Park’s first reminder letter) to lodge an application for Review. Send your application for Review to: Disputes Officer Care Park Pty Ltd GPO Box 3022 BRISBANE QLD 4001 by fax to: 1300 011 999 or email: qldpaymentnotices@carepark.com.au Not the driver? You may either pay the Payment Notice and ask the driver to reimburse you or alternatively, complete and return a Statutory Declaration Nomination of Driver Form (available from the Care Park website) stating that you were not the driver of the vehicle at the relevant time and identifying the name and address of the person who was driving.
What should be included with the application for Review? You must tell us the Payment Notice number or the vehicle registration number. Please include all relevant information and documents available. This may include:
• Original pay and display parking ticket or receipt (or a certified copy)
• Photographs and diagrams
• Statutory declarations from witnesses What happens next and how long does it take?

The Disputes Officer will consider the application for Review and may:
• Request further information or make further inquiries
• Waive the Payment Notice or
• Confirm that the Payment Notice stands.
Important Note Care Park reserves the right to not investigate a complaint that is abusive or offensive. To ensure your application for Review results in a fair and speedy resolution, you are asked to show a genuine willingness to resolve your complaint by dealing with Care Park in a reasonable and co-operative manner. You will be notified in writing of the decision of the Disputes Officer. Most applications for Review are finalised within 14 days, although some may take longer, particularly where further information is required. However, no legal action will be instituted until the application is determined. What if my appeal is unsuccessful? If the Payment Notice stands after the Disputes Officer has considered your application for Review, you have two options:
1. Pay the Payment Notice and the matter is settled; or
2. Await service of legal proceedings and defend those proceedings in Court. Privacy Statement As part of the Care Park complaint handling procedure, you are asked to submit personal information about your complaint. This information is required to enable assessment and investigation and to enable Care Park to make a decision. Supply of this information by you is voluntary. However, failure to provide the information in whole or part, may mean that Care Park is unable to thoroughly assess you application.

Need further information?
- Visit paymentnotices.com.au
- Call: 1300 760 544 or
- Contact a legal practitioner of your choice.

© Care Park Pty Ltd 2007-08. ABN 47 083 921 215 DMS|CP 80459D
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