Hearing Request Form

Today's Date

Month

Day

Year

First name

Last name

Address

Email

Phone

Account Number (Included on Violation Letter)

Date of Violation Notice

Month

Day

Year

Violation Type

Traffic Violation - Speeding

Traffic Violation - Stop Sign

Other Violation

Hearing Request:

I, the undersigned homeowner, request a hearing before the Hackberry Creek Home Owners Association Board to address the above-referenced violation. I understand that this hearing is an opportunity to present any relevant information, clarification, and dispute related to the Violation.

Reason for Requesting a Hearing (briefly explain your reason for contesting or discussing the violation):

You will receive a confirmation of your scheduled hearing date and time within 2 business days of this submission.