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New Complaint - Business
Complaint - Business Inquiry
Portal Business Inquiry
Prior to filing your complaint you may wish to have:
The business name.
A copy of the contract.
Any supporting documentation.
Please note that after you start this process, your web session will timeout after 45 minutes. You will be notified if this happens.
Information that is marked with an asterisk is required.
On the following pages please complete all of the required data and as much as the non-required data as you can.
Enter Business name – if the business name is in the drop down menu, please select the one you want. If the business name is not in the drop down menu, please proceed to the next line Business found? And select NO, this will allow you to enter the Business name
Consumer Information
First Name
*
Last Name
*
Date Of Birth
*
Age Group
Under 18
18 - 29
30 - 39
40 - 49
50 - 59
60 and up
Ethnicity
African American
American Indian or Alaskan Native
Asian
Hispanic or Latino
Multiple
Native Hawaiian
Other
Unknown
White
Military Status
Active Duty
Discharged
Not Applicable
Reserve
Retired
Address 1
*
Address 2
City
*
State
*
Aguascalientes
Alabama
Alaska
Alberta
Arizona
Arkansas
Baja California
Baja California Sur
British Columbia
California
Campeche
Chiapas
Chihuahua
Coahuila
Colima
Colorado
Connecticut
Delaware
District of Columbia
Distrito Federal
Durango
Florida
Georgia
Guanajuato
Guerrero
Hawaii
Hidalgo
Idaho
Illinois
Indiana
Iowa
Jalisco
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Mexico
Michigan
Michoacan
Minnesota
Mississippi
Missouri
Montana
Morelos
Nayarit
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northwest Territories
Not Given
Nova Scotia
Nuevo Leon
Oaxaca
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puebla
Quebec
Queretaro
Quintana Roo
Rhode Island
San Luis Potosi
Saskatchewan
Sinaloa
Sonora
South Carolina
South Dakota
Tabasco
Tamaulipas
Tennessee
Texas
Tlaxcala
USA
Utah
Veracruz
Vermont
Virginia
Wake Island
Washington
West Virginia
Wisconsin
Wyoming
Yucatan
Yukon
Zacatecas
Zip
*
County
*
Phone Number
*
Email
Business Information
Business Name
*
Business found?
No
Yes
Business Name
*
Address 1
*
Address 2
City
*
State
*
Aguascalientes
Alabama
Alaska
Alberta
Arizona
Arkansas
Baja California
Baja California Sur
British Columbia
California
Campeche
Chiapas
Chihuahua
Coahuila
Colima
Colorado
Connecticut
Delaware
District of Columbia
Distrito Federal
Durango
Florida
Georgia
Guanajuato
Guerrero
Hawaii
Hidalgo
Idaho
Illinois
Indiana
Iowa
Jalisco
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Mexico
Michigan
Michoacan
Minnesota
Mississippi
Missouri
Montana
Morelos
Nayarit
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northwest Territories
Not Given
Nova Scotia
Nuevo Leon
Oaxaca
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Puebla
Quebec
Queretaro
Quintana Roo
Rhode Island
San Luis Potosi
Saskatchewan
Sinaloa
Sonora
South Carolina
South Dakota
Tabasco
Tamaulipas
Tennessee
Texas
Tlaxcala
USA
Utah
Veracruz
Vermont
Virginia
Wake Island
Washington
West Virginia
Wisconsin
Wyoming
Yucatan
Yukon
Zacatecas
Zip
*
Date of Incident
*
Product/Service
*
Advertisement Agencies
Agriculture
Ambulance Service
Antitrust
Appliances
Asphalt, Concrete, Paving
Barbers, Salons, Cosmetologists
Boats, Jet Ski, Watercraft
Business Opportunities
Business vs. Business
COVID-19
Cable Television
Caterings
Cell Phone Products
Cell Phone Providers
Cemeteries
Cleaning Services
Clothing & Apparel
Collection Agency
Computer Software/Hardware
Computers
Concerts, Theaters, Sporting Events
Correctional Facility
Credit Reporting Agencies
Credit/Debit Card Equipment
Credit/Debit Cards
Day Cares
Debt Management
Debt Relief
Debt Settlement
Department Stores
Education & Training
Electricians
Electronics
Employment Wages
Entertainment
Equipment Rentals
Eye Care
Farm Equipment
Financial
Flooring
Florists
Food & Beverage
Gambling, Raffles, Contests
Garnishments, Judgements, Litigation
Gasoline
Gift Card
Government Agencies
Grocery Stores
Guns & Firearms
Health Clubs
Hearing Aids
Heating & Air Conditioning
Home - Construction & Remodel
Home - Roofing
Home - Siding
Home - Windows & Doors
Home Inspectors
Home Loan/Mortgage
Home Warranty
Homes - Manufactured
Homes - Mobile
Hospitals
Hot Tubs & Pools
Hotels, Motels, Campgrounds
Household Goods
ID Theft
Individual vs. Individual
Insect/Pest Control
Insurance
Internet Service Providers
Internet Streaming Services
Investments
Jewelry
Landlord/Tenant
Lawn Care & Landscaping
Lawn Equipment
Meat and Game Processing
Medical Equipment
Medical Services
Motorcycles & ATV's
Multi-Level Marketing
Newspapers & Magazines
Non - Jurisdictional
Non - Profit
Office Supplies
Online Purchase
Pawn Shops
Pay Day & Online Loans
Pet Stores
Pets
Photography
Plumbers
Political
Professional Services - Other
Propane Fuels & Tanks
RVs & Campers
Real Estate
Restaurants
Satellite Television/Radio
Secretarial Services
Security Breach
Security Freeze
Security Systems
Sports Equipment
Surveys
Tattoo Shops
Tax Preperation
Taxidermists
Telephone
Toys & Collectibles
Transportation
Trash & Recycling
Travel - Crusies & Tours
Travel Accessories
Travel Agencies
Unauthorized Practice of Law
Unknown Call
Unknown Mail/Fax
Utilities
VOIP
Vehicle - Accessories
Vehicle - Lease
Vehicle - New
Vehicle - Odometer Fraud
Vehicle - Rental
Vehicle - Repair & Service
Vehicle - Towing
Vehicle - Used
Vehicle - Warranty
Vehicles - Other
Vitamins & Supplements
Problem Type
*
Bait & Switch
Billing Issues
Collection Practices
Deceptive Advertising
Defective Product or Installation
Do Not Call
Failure to Deliver Product / Service / Refund
Foreclosure
General Inquiry
Harassing Phone Calls
Non - Jurisdictional
Notice of Dissolution
Out of Business
Personal Sales Solicitation Act
Price Gouging
Rebate
Rental / Lease Agreements
Repairs or Service
Return / Refund / Cancellation Policy
Review Tax Return
Service Contracts
Unauthorized Financial Transaction
Unauthorized Practice of Law
Warranty / Guarantee
Attorney Retained?
*
Yes
No
Business Contacted?
*
Yes
No
Additional Information
Complaint Description
*
Fully explain the nature of your complaint. Describe events in the order in which they occurred. Be sure to include how much money was paid, the date of transaction, whether a contract was signed, etc.
Desired Resolution
*
State the relief you desire, i.e. refund, repair, etc.:
NOTE: If you desire legal advice, we suggest you contact a private attorney to handle your complaint.
I understand that:
the State has full discretion concerning its acceptance, investigation and resolution of this complaint;
the State cannot act as my attorney; and
no attorney/client relationship is established as a result of any activities undertaken on my behalf.
I hereby:
affirm that this complaint is true and correct to the best of my knowledge; and
authorize the use of my name and this complaint in investigating the company or individual complained of.
I agree to the terms and conditions stated above.
*
Print for your own records, or to mail in.
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