Wynnfield Lakes Resident Complaint Form

DATE: 		TIME: 	

COMPLAINT RECEIVED BY: 	

NAME OF COMPLAINANT: 	

ADDRESS OF COMPLAINANT: 	

TELEPHONE NO.: 	

LOCATION OF COMPLAINT: 	

NATURE OF COMPLAINT:	

SIGNATURE:	DATE:

********************************OFFICIAL USE ONLY************************************* COMPLAINT ASSIGNED TO: 	
RESPOND IN WRITING	 YES 	  NO 	 RETURN PHONE CALL	YES 	 NO