Appeals for the waiving of library fines must be made in writing on this form and submitted to
the Circulation Supervisor.  After your appeal form has been reviewed, you will be notified of the
decision (this will take approximately 1 - 4 days). Your circulation privileges will be reinstated during the appeals process.

Please state the reasons which you believe justify the waiving of your overdue fine(s).  Please
refer to the fine policy  when making your appeal. It will be to your benefit to supply any
documents which may support your case (e.g., police reports in cases of theft, obituaries or death
certificates, etc.).

Please attach any supporting documents, as well as a copy of your fine notice to this form.
 
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Your name ________________________________________________   Date ________

Email _______________      Phone _______________