Plain Pleading

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*PLEASE READ: In order to process your complaint, the Attorney General's Office will send a copy of your request for ... Have you contacted a private attorney?

MANUFACTURED HOUSING DISPUTE RESOLUTION PROGRAM

REQUEST FOR DISPUTE RESOLUTION

OFFICE OF THE ATTORNEY GENERAL Consumer Protection Division STATEWIDE TOLL FREE 1-866-924-6458; KING COUNTY 206-464-6049 REVISED 1/10

HOMEOWNER INFORMATION  Name ________________________________________________________________________________________________________________________________ Please Print or Type Last First Middle Initial Address:_______________________________________________________________________________________________________________________________ City:__________________________________________________________________________State______________Zip___________________________________ Phone: Day: (______) ___________________ Evening: (______) ______________________ E-mail address: ___________________________________________

LANDLORD INFORMATION Name of Park/Community: ________________________________________________________________________________________________________________ Name of Owner or Property Manager________________________________________________________________________________________________________ Please Print or Type Last First Middle Initial Address:_______________________________________________________________________________________________________________________________ City:________________________________________________________ State:_____________________________ Zip:____________________________________ Phone: (______)______________ Fax: (______) ______________ E-mail address: __________________________________ Name of On-site Manager, including house or site number________________________________________________________________________________________ Phone: (______)______________ Fax: (______) ______________ E-mail address: __________________________________

ABOUT YOUR ISSUE *PLEASE READ: In order to process your complaint, the Attorney General’s Office will send a copy of your request for dispute resolution to the other party. May the Attorney General’s Office forward this other party a copy of your request? I understand that if I answer “No”, the Attorney General’s Office will not process this request. Yes  No  I understand my request and any related documents I have submitted will become public record. Under state law, public records are subject to public records disclosure requests. Under some circumstances, my request and related documents may be seen by other people. Please keep this in mind when giving us personal information such as Social Security, credit and bank account numbers, and medical information. Is there a signed lease agreement?________ Date entered into the lease: ____/____/____ Describe what outcome you would like to have: ________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ Have you attempted to resolve this issue directly with the other party? Yes  No  If YES, to whom: (and their position)___________________________________ If yes, what was the response? ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________ If no, why not? __________________________________________________________________________________________________________________________ Have you filed anything about this other party with the Attorney General’s Office before? Yes  No 

If Yes, list the file number ___________________________

Have you contacted a private attorney? Yes  No  If YES, identify the name and contact information of the attorney: _______________________________________________________________________________________________________________________________________ Is there a court or other legal proceeding pending? Yes  No  If YES, please explain:______________________________________________________________ _______________________________________________________________________________________________________________________________________

EXPLAIN YOUR ISSUE IN DETAIL (use additional pages if necessary). ATTACH COPIES OF OTHER DOCUMENTS, SUCH AS CORRESPONDENCE, RULES & REGULATIONS, LEASES, NOTICES, ETC. DO NOT SEND ORIGINAL DOCUMENTS:

____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________

PLEASE TYPE OR PRINT. After your complaint is received, you will be contacted by mail or email regarding assignment of your request.

RETURN TO:

WA State Attorney General’s Office Manufactured Housing Unit 800 FIFTH AVENUE, SUITE 2000 SEATTLE, WA 98104-3188 fax (206) 587-5636

Please include copies of related documents such as correspondence, rules & regulations, notices, leases, etc. SEND COPIES ONLY - DO NOT INCLUDE ORIGINAL DOCUMENTS

E-MAIL NOTIFICATION The Attorney General's Office will periodically issue press releases, consumer warnings and other notifications to the public. We would like to include you in our e-mail list for these notifications. Please check "Yes" if you want to receive these notifications.

Yes  No 

SIGNATURE I declare, under penalty of perjury under the laws of the State of Washington, that the information contained in this complaint is true and accurate, and that any documents attached are true and accurate copies of the originals.

I understand that my request for dispute resolution and the related documents will become a “public record” and under state law may be subject to a public records disclosure request and thus be seen by other people.

Signature

Date

City and State where signed

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