Consumer Complaint Form Please fill out the online form below. If you prefer to print the form and mail it to us, please Click Here. Name of Company (required) Name of Contractor (required) Address (required) City (required) State (required) ZIP Code (required) Telephone (required) Your Name (required) Property Address (required) Mailing Address (required) City (required) State (required) ZIP Code (required) Telephone (required) Email (required - you will receive a copy of your responses to this form) Date Work Performed Have you consulted an attorney? YesNo Action Pending? YesNo Did you sign a contract? YesNo If Yes, please provide the date YOU MUST INCLUDE COPIES OF ALL PERTINENT INFORMATION SUCH AS INVOICES,CANCELLED CHECK, CONTRACTS, WARRANTIES,ETC. THE BOARD WILL NOT CONSIDER COMPLAINTS WITH INSUFFICIENT DOCUMENTATION. Please explain the circumstances surrounding your complaint including your attempts to rectify the situation with the contractor. Please attach required supporting documentation below: I have attached copies of all papers that relate to this complaint. I understand that in order to successfully handle this complaint the Consumer Protection Unit may need to send this complaint to the person or business I have complained about. The information contained in this complaint is true to the best of my knowledge. Name Date
