Form cover
Page 1 of 2

Appeality Community Relief Draw

Apply for consideration under the Appeality Community Relief Draw. Complete the form below with accurate PCN details, confirmation of eligibility, and the information required for internal review.
No purchase necessary. Please ensure all required fields are completed and that the information matches the notice as closely as possible.

1. Entrant details

Full Name

Email

Phone

Council / area

Relationship to the PCN

Name of person receiving support


2. Social entry route

Social channel

Social username / handle

How did you enter?

Website / URL


3. PCN details

Notice type

Issuing authority / issuer

PCN number / reference

Vehicle registration

Contravention or issue date

Current payment deadline

Discounted amount due

Current outstanding amount

Still within discounted payment window?

Current appeal status

Why should this entry be considered?

Supporting evidence (optional)

Upload the PCN, screenshots, or supporting evidence if available.

4. Eligibility and permissions

I confirm I am aged 18 or over.

I confirm I am aged 18 or over.

I confirm I am a UK resident.

I confirm I am a UK resident.

I confirm I am the named recipient of the PCN or I have authority to act for that person.

I confirm I am the named recipient of the PCN or I have authority to act for that person.

I agree to the Community Relief Draw Terms, Terms & Conditions, and Privacy Policy.

I agree to the Community Relief Draw Terms, Terms & Conditions, and Privacy Policy.

I would like to receive optional marketing updates from Appeality.

I would like to receive optional marketing updates from Appeality.
By submitting this form, you confirm that the information provided is accurate to the best of your knowledge and may be reviewed for eligibility, verification, and winner selection purposes in line with the published terms.