Meadow Lakes Homeowners Association

                                               RULE INFRACTION REPORT

Description of infraction: (please be specific):_______________________________

__________________________________________________________________

__________________________________________________________________

Location: ___________________________________________________________

Date(s) and time(s): __________________________________________________

___________________________________________________________________

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: __________________________________

__________________________________________________________________

__________________________________________________________________

Your signature: _____________________ Your address: _____________________

Print your name: ____________________  Telephone: _______________________

Email: _______________________________________  Date: ________________

Please mail this form to:
            Meadow Lakes Homeowners Association
            c/o Barnett Management, Inc.
            3681 Green Road,. Suite 305
            Beachwood, OH  44122

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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Date Received: ______________________      Received By: _________________________