Description of infraction: (please be specific): __________________________________

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Location: ________________________________________________________________

Date(s) and time(s): _______________________________________________________

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Name of alleged offender (if known): __________________________________________

Address (if known): ________________________________________________________

Was any attempt made to resolve this problem?     Circle:        Yes          No
If "yes", describe the attempt and results: ______________________________________

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Your signature: __________________________ Your address: _____________________

Print your name: _________________________   Telephone: ______________________

Email: _______________________________________  Date: ______________________

Please mail this form to:    Meadow Lakes Homeowners Association
                                      c/o M2 Management Group
                                      455 Pearl Road
                                      Brunswick, OH 44212

All complaints determined to be actionable will be handled according to the Meadow Lakes Homeowners Association Enforcement Procedure.  All complaints must be signed to be enforceable.  Your name will not be divulged unless a legal hearing is necessary.
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Page Revised April 1, 2009