Date:___________________

Name:___________________________________________

Address :_________________________________________ Unit No.:________

Home Phone:___________________ Work Phone:________________________

Nature of service request, rule violation or complaint. Please detail specifics:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

If you are reporting a grievance against another unit owner, please list their name and unit number. After completing report, submit it to the management company at the following address:

TAYLOR MANAGEMENT CO.

100 Hanover Avenue, 4th Floor

Ceder Knolls, NJ

All correspondence received by the Management Company will be addressed and forwarded to the Board of Directors and the Covenants Committee.