Individual Lost/Stolen Affidavit

I understand that my signature authorizes the Transportation and Parking to place the permit/gate access card listed above on a Tow List. Any vehicle found using the permit/gate access card will be towed without question and the party responsible for the vehicle will be issued a $200.00 citation. I also understand that the use of this permit by anyone other than whom it was originally issued is prohibited. Should duplication, resale, transfer, or alteration of the permit occur, all parties involved are subject to a fine of up to $200.00, impoundment fees, and forfeiture of permit privileges in accordance with The Ordinance Regulating Traffic and Parking on the Campus of The University of North Carolina at Chapel Hill.

There is a $25.00 replacement fee for a lost permit and a $10.00 replacement fee for a gate access card.

A police report must accompany permits or gate access cards cards reported as stolen. The Department of Public Safety will only file a police report in cases where it is positively determined that a larceny has taken place and that it occurred within the Department of Public Safety’s jurisdiction. Filing of a false police report is subject to criminal investigation.