Get CA FasTrak DMVHR4RW 2008-2024

IMPORTANT Submittal of this Request for Review Form will not 1 release the current hold on your DMV vehicle registration 2 suspend any Franchise Tax Board actions 3 stop the process of additional violations being sent to DMV Hold and/or Collections or 4 recall violations which have already been sent to Collections. FasTrak Customer Service Center PO Box 26925 San Francisco CA 94126 www. bayareafastrak. org 1-877-BAY-TOLL 1-877-229-8655 Fax 1-415-956-1663 For Office Use Only Date Received Case Code DMV Registration Hold Request for Review Form INSTRUCTIONS If there was a hold placed on your DMV vehicle registration due to unpaid toll violations you may request a review of your dispute by completing this form use a separate form for each license plate number. Fill in the information requested print it out and send it to the address above. To expedite your request please include a copy of your current DMV registration DMV registration renewal and/or documentation of violations already paid directly at the DMV. Within 15 business days from submittal of this form a letter will be sent to you with the required payment amount due from you along with a list of all unpaid violations. Registered Vehicle Owner Information Last Name First Name Vehicle License Plate Number Current Mailing Address State of Registration City State Postal Code Current FasTrak Account Number if any Contact Phone number s Previous FasTrak Account Number if any Violation Number s If more space is needed attach additional sheets. Written Dispute If more space is needed attach additional sheets. Print Name Signature Date Print Form DMVHR4RW v1. Fill in the information requested print it out and send it to the address above. To expedite your request please include a copy of your current DMV registration DMV registration renewal and/or documentation of violations already paid directly at the DMV. Within 15 business days from submittal of this form a letter will be sent to you with the required payment amount due from you along with a list of all unpaid violations. Registered Vehicle Owner Information Last Name First Name Vehicle License Plate Number Current Mailing Address State of Registration City State Postal Code Current FasTrak Account Number if any Contact Phone number s Previous FasTrak Account Number if any Violation Number s If more space is needed attach additional sheets. Written Dispute If more space is needed attach additional sheets. Print Name Signature Date Print Form DMVHR4RW v1. .