File a Complaint

 
YOUR INFORMATION
 
Your First and Last Name
Address
City
State
Telephone Number
Email
 
COMPANY INFORMATION
Name of business complaint is against
Name of individuals to whom you complained
Company Address
Company City
Company State
Company Telephone Number
Product or Service Purchased
Date of Purchase
Purchase Price
 
OTHER AGENCIES
What action has been taken so
Have you retained an attorney?
YesNo
If Yes, Attorney Name
Attorney Address
Attorney City
Attorney State
Attorney Telephone Number
 
ADDITIONAL INFORMATION
Have you filed a legal action?
YesNo
If Yes, please state WHEN
WHERE
WHAT decision was made?
 
COMPLAINT INFORMATION
Please explain your complaint: Try to be brief, but be sure to tell WHAT happened, WHEN it happened and WHERE it happened. Be specific about any oral statements the business made to you, ESPECIALLY those that influenced you to deal with the company. Describe events in the order in which they happened, referring to all contracts, letters, receipts, cancelled checks, advertisements or other papers that will support your claim. If you have documents or other evidence to support your complaint, it will save time if you print out the pdf complaint form from complete it and mail it to the office with all documentary and other materials related to your complaint.

What would you like the business to do to settle your complaint?

PLEASE READ CAREFULLY
The Business Accreditation Bureau cannot act as your private attorney.
The Business Accreditation Bureau provides a mediation service to consumers where an attempt may be made to mediate your individual consumer complaint if it falls within the jurisdiction of the office. Please be advised that the information you provide will be shared with the party against which you have filed a complaint. Additionally, your complaint may be shared with or referred to other Governmental Law Enforcement or Regulatory Agencies.
Your complaint will also be kept on file with our office and the information contained therein may be used to for future use. Attached to this complaint form is an informational sheet, which will help you in completion of the complaint form and also will explain in greater detail the mediation process.
By completing and submitting this complaint form, I am adopting this as my online signature and I authorize the Business Accreditation Bureau to contact the party (ies) against which I have filed a complaint in an effort to reach an amicable resolution. I further authorize the party (ies) against which I have filed a complaint to communicate with and provide information related to my complaint to the Business Accreditation Bureau. I verify that I have read and understand the informational sheet about this process; and, that the information provided is true and correct to the best of my knowledge, information and belief.