Complaint Form

California Department Of Justice
Office of the Attorney General
On-line Consumer Complaint Form

I wish to file a complaint against the company named below. I understand that the Attorney General does not represent private citizens seeking the return of their money or other personal remedies. I am, however, filing this complaint to notify your office of the activities of this company so that it may be determined if law enforcement or legal action is warranted.
Party Complaining_____Complaint Against Address: Address:
_ _________________________
Telephone:(_)________________________ Telephone:(_)___________

Name of Product Or service involved:
Date of Purchase:_
Was a contract signed? Yes No (Circle)
If so, please include a copy of the contract with your complaint. Keep all originals of documents and contracts.
Can we send this complaint to the party you are complaining about? Yes No (Circle)
Please provide a brief description of what happened. If more space is needed, use the back of this sheet or attach additional sheets as needed.

______
The above information is true and correct to the best of my knowledge.

Signed_ Date______

When completed, return this form to:
Public Inquiry Unit
P.O. Box 944255
Sacramento, CA 94244-2550