HSAC Case Form No. 2 HOA COMPLAINT
HSAC Case Form No. 2 HOA COMPLAINT
HSAC Case Form No. 2 HOA COMPLAINT
02
______________________
______________________
______________________,
Complainant/s,
- versus -
HSAC Case No. ____-________-______
______________________
______________________
______________________,
Respondent/s.
x----------------------------------------------------x
COMPLAINT
(Note: If more space is needed, please use additional sheet, indicate “Continuation of Par. 1”, and countersign.)
(Note: If more space is needed, please use additional sheet, indicate “Continuation of Par. 2”, and countersign.)
3. This complaint is for: (Please check as are applicable.)
(Note: If more space is needed, please use additional sheet, indicate “Continuation of Par. 3”, and countersign.)
COMPLAINT || Page 2
4. The above violation(s) was/were committed as follows: (For each violation checked
or cited above, briefly and clearly narrate the facts, incidents or circumstances that
led to the filling of this complaint, stating the dates of occurrence, persons involved
and the specific acts done by the respondent(s).)
COMPLAINT || Page 3
(Note: If more space is needed, please use additional sheet, indicate “Continuation of Par. 4”, and countersign.)
5. As evidence of the foregoing facts and circumstances, I/we are attaching the
following documents and affidavit as Annexes to this Complaint:
Purpose of Document
Annex Description of
(What fact or circumstance does the
Document
document prove or show?)
“A”
(Note: If more space is needed, please use additional sheet, indicate "Continuation of Par. 5", and countersign.)
(1) ____________________________________________________
____________________________________________________
(2) ____________________________________________________
____________________________________________________
(3) ____________________________________________________
____________________________________________________
(4) ____________________________________________________
____________________________________________________
(5) ____________________________________________________
____________________________________________________
(Note: If more space is needed, please use additional sheet, indicate "Continuation of Par. 6", and countersign.)
COMPLAINT || Page 4
8. Complainant(s) also pray(s) that, pending the resolution of the case, the following
provisional remedy(ies) be issued in accordance with Part 3 of the HSAC Rules of
Procedure:
COMPLAINT || Page 5
VERIFICATION AND CERTIFICATION AGAINST FORUM SHOPPING
1. That I/we am/are the complainant(s) in the above-entitled case and have
caused this Complaint to be prepared;
2. That I/we read and understood its contents which are true and correct of
my/our own personal knowledge and/or based on true records; and
3. That I/we have not commenced any action or proceeding involving the same
issue or subject matter in the Supreme Court, the Court of Appeals or any other
tribunal or agency; that to the best of my/our knowledge, no such action or
proceeding is pending in the Supreme Court, the Court of Appeals or any other
tribunal or agency; and that if I/we should learn thereafter that a similar action
or proceeding has been filed or is pending before these courts or tribunal or
agency, I/we undertake to report that fact to the Commission within five (5)
calendar days therefrom.
_
__________________________
Complainant(s)
COMPLAINT || Page 6