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Student Decal Application Form

This document is a parking permit application for the University of Southern Maine. It requests information such as the applicant's name, date of birth, contact details, vehicle registration details, and type of permit being requested. The applicant must acknowledge their responsibility to follow parking rules and pay any fines. It provides contact information for the Parking and Transportation Services Office and explains that possession of a permit does not guarantee an available parking spot. Vehicles in violation of rules may be cited, towed, or immobilized.

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Bruno Salazar
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35 views3 pages

Student Decal Application Form

This document is a parking permit application for the University of Southern Maine. It requests information such as the applicant's name, date of birth, contact details, vehicle registration details, and type of permit being requested. The applicant must acknowledge their responsibility to follow parking rules and pay any fines. It provides contact information for the Parking and Transportation Services Office and explains that possession of a permit does not guarantee an available parking spot. Vehicles in violation of rules may be cited, towed, or immobilized.

Uploaded by

Bruno Salazar
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Date received:______________________

PARKING PERMIT APPLICATION


Please provide a copy of current vehicle registration at time of application

Type of permit requested – check only one:

Resident Commuter Motorcycle Gym Member Other


___________
Clearly print current information requested below:
Name: _______________________________________D.O.B: _________________________

Email address: ________________________________________________________________

Campus/local information:
Address: _________________________________________ Cell: ______________________

City: ______________________________State: __________ Zip: _____________________


Home information:
Address: ________________________________________Phone: ______________________

City: _______________________________State: _________Zip: ______________________


Vehicle Information: Are you the registered owner of this vehicle? Yes No

Plate # Plate type State Make/Model Color Year

__________________________________________________________________________________________
Plate # Plate type State Make/Model Color Year
Plate types:
PC = Passenger CR = Conservation TS = Troop Support BC = Breast Cancer Awareness AG = Agriculture VT = Veteran
SW = Sportsman LB = Lobster UM= UMaine System CO = Commercial CM = Combination BB = Black Bear DX = Disability
IMPORTANT: BE SURE TO READ THE INFORMATION ON THE REVERSE SIDE. SIGN THE FORM
WHERE INDICATED AND INCLUDE PAYMENT IF NECESSARY.

AMOUNT PAID: _____________ TYPE OF PAYMENT: SB / CASH / CHECK / BC / IDO

PERMIT #/TYPE ISSUED:_______________ DATE/PERSON WHO ENTERED: _______________


Please complete this application, read and sign below.

Purchase in person at: Parking & Transportation Services Office


Level One of Parking Garage
88 Bedford Street
Portland, Maine 04104

Submit by mail to: University of Southern Maine


Parking & Transportation Services Office
96 Falmouth Street
P.O. Box 9300
Portland, Maine 04104-9300

Fines for any outstanding violations must be paid prior to issuance of a new permit. Questions may be directed
to the Parking & Transportation Services office, 780-4718, open from 7:30 AM – 6:00 PM, Monday through
Friday.
Responsibility Acknowledgement
I understand that:

 Knowledge of the parking rules is my responsibility and I agree to observe all of the University of
Southern Maine Motor Vehicle Rules, http://www.usm.maine.edu/police/aboutpt.htm
 If any of these rules are unclear to me, I should contact the Parking & Transportation Services Office for
clarification prior to parking in a questionable place or manner
 The permit issued to me is for my personal use and it is my obligation to see that it is properly displaced
at all times
 The permit remains the property of the University of Southern Maine and that I am paying for the
opportunity to park on campus.
 Possession of the parking permit does not ensure there will be a spot available
 Any alteration to, or unauthorized use of, the permit is a violation that will be referred to the Police
Department
 Any vehicle connected to me by being listed on this form, displaying a permit assigned to me, registered
with a state in my name, or that I drive to campus is subject to being cited and possibly impounded,
towed, and stored or immobilized at my expense when found in violation.
 Lack of a convenient parking space is not a valid reason for parking in violation of the rules as stated on
our website http://www.usm.maine.edu/police/aboutpt.htm

I agree to promptly pay fees for all citations received without further notice. I understand that an appeals
process is available and I must file my first appeal within ten days of receiving the citation. Appeals seeking
exemption or exclusion from the established parking rules will not be considered. Violation totals in excess of
$100 could result in your vehicle being towed, booted and/or a hold placed on your student account preventing
registration for classes and the receipt of a transcript.

I further acknowledge that the University of Southern Maine neither assumes nor has any responsibility for
damage to any vehicle parked on the University property or any vehicle that is damaged while being towed,
immobilized or stored.
Signature: ________________________________________________Date: ___________________________

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