[Your address and full contact details]
[Issuing authority address]
To whom it may concern,
[Reference:
Penalty Charge Notice number: xxxxx
Date of issue: xxxxx
Vehicle registration: xxxxx]
I am writing to formally challenge the above Penalty Charge Notice.
On [date] my vehicle was issued with a Penalty Charge Notice for the reason of [offence code and official reason for issue as stated on the Penalty Charge Notice.]
My challenge is on the basis that the contravention did not occur. [State the reasons why]
Please find enclosed evidence to this effect, in the form of [if evidence is available, state the details and why it backs up your case].
For this reason I look forward to receiving notification that the Penalty Charge Notice has been cancelled within 28 days.
Regards,
[Your name and signature]