Complaint Form

Complaint regarding alleged violation of Pine Mountain Lake Association Governing Documents

Date

A. Name of person Alleged to be in Violation of CC&R's ("Respondent"):

Name

First

Last

Address and/or Unit & Lot

Appears to be in violation of the Governing Documents of the Pine Mountain Lake Association.

B. Statement of Violation(s) Please set forth, in ordinary and concise language, the acts or omissions which you believe to be in violation of the Pine Mountain Lake Governing Documents:

Statement

C. Governing Document Provisions. Please note the specific provision(s) of the CC&R's, Bylaws or Association Rules and Regulations which the Respondent is alleged to have violated:

Governing Document Violated

D. Other Information Concerning Violation/Witnesses.
Set forth specifics as to time, date, locations, persons involved or known witnesses:

Other Information

E-Signature

Phone

Address and/or Unit & Lot

Email

** The Complainant may be responsible for acting as witness to violations in the event that further information is required by the Covenants Committee or ECC.