Person Reporting the Violation:

Name:* Address:*

Phone No: * E-Mail:

Witness to Violation:

Name: * Phone No.:

Person suspect of Violation:

Name or Address: * Date/Time of Violation:

Which Covenants, Codes, & Restrictions Applies to Violation:

Article & Title: Section: Item#: Paragraph:
Brief Description of Violation:


Which Rules & Regulations Applies to Violation:

Section: Item#: Paragraph:
Brief Description of Violation:

* * * FAILURE TO CITE WHICH RULE IS BEING BROKEN INVALIDATES THIS REPORT. * * *

This form is intended to provide the Pawleys Place Homeowners Association Board of Directors
with advice on residents of our town home community that are not in compliance with the Covenants,
Codes, Restrictions (CC&R) and Rules and Regulations (R&R) approved and adopted by the Association.
This form is not intended to file personal complaints.
The form must be fully completed and presented to the community property management company, as well
as a memberof the HOA Board of Directors. The submission of the form is on an advisory capacity to
the Board of Directors and is not to be used as a notification to the alleged violator or to assume 
any action to be taken by the property management company nor the HOA Board of Directors.

SAVE