Consumer Complaint Form

MANUAL FORM
Please fill out the form in its entirety and return it to the Division with copies of any relevant documentation.  You will be contacted by the Division after your complaint has been reviewed.

Consumer Complaint Form (110 KB)  Submit form by mail or facsimile. Please limit faxed complaints to ten total pages or less. Complaints with a large number of supporting documents should not faxed, but should be mailed to the Division.

TIP: Right-click to save the form for later use.

You must have the free Adobe Acrobat Reader installed to view/download the Consumer Complaint Form (.pdf format ).

DISCLAIMER: The latest version of Adobe Acrobat Reader is recommended; electronic submission may NOT be compatible with all email clients, computer systems, etc.  If you experience problems electronically submitting the form, please send the form by mail or fax.  If you experience problems obtaining the form, please contact the Division so we may assist you.