E.P.O.A. Board of Directors
Report of Grievance/Appeals
Be Advised: Hearing dates and times will be set by authorized personnel and are non negotiable. The appellant may cancel one
time with 48hr prior notification to the office but must appear at the next scheduled meeting or the appeal will be heard and a
decision rendered without their presence. Therefore it is required that you fill out this form with all information pertinent to your
grievance/appeal, Attach any documentation of the information contained herein. This form will be used as an aid by the committee.
All properly scheduled grievance/appeals will be heard with or without your presence. This form is the only accepted form of
grievance/appeal. By signing this form you have affirmed you have read and understand this procedure.
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Name___________________________
Address_________________________________________________________________
Lot No._________________
Date___________________
Signature____________________________________