Complete this form with your details to request the Police Infringement Bureau to send you a copy of the safety camera photo relating to the infringement notice issued to your name.

Only the person named on the original infringement notice or an authorised representative of a company or incorporated body can request a safety camera photo.

Please complete a separate form for each notice holder.

Please note: you will not receive an acknowledgment email.
Box or House number and Street name
Include RD number if relevant