Application For Late Fee Waiver

Use this form to request that the Board of Directors review and waive a late fee or other charge on your account.

Homeowner & Property Information

Association Name

Homeowner Account #

Owner Name(s) *

Property Address (include unit # if applicable) *

Telephone # *

Email *

Request Type

Please Check One *

Late Fee Removal RequestOther Charge Removal Request

Total Late Fees Amount

Total Other Charges Amount

Type of Other Charges

Explanation

Please explain why you believe the Board should waive the above referenced fee(s): *

You are responsible to continue making payments while your request is being reviewed. Additional late fees and collection fees may be added in accordance with your Association's collection policy. The Board of Directors will be presented with this request at the next regularly scheduled board meeting. After the Board review, you will receive written notification of the Board's final decision. Submitting a request does not constitute approval, as all waivers must be approved by the Board of Directors.

Signature *

Date *

Please return this form to your community manager.

For Internal Use Only

Manager Signature

Date

Board Denied – notice sent by Manager on

Board Approved (Attach Board Approval) – notice sent by Manager on

Account Adjusted & Cleared

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Application For Late Fee Waiver

Homeowner & Property Information

Request Type

Explanation

Address

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