Consumer Complaint Form

When applicable, your complaint will be handled by the Better Business Bureau (BBB) in the service area where the business is located. In some cases, your complaint may also be forwarded directly to the business or applicable law enforcement agencies. Before filing a complaint, our office would recommend you try to resolve your dispute with the company’s management.

To protect your privacy, we strongly recommend that you remove all personal confidential information, such as Social Security numbers, bank account and credit card numbers, and medical information from copies of any documents you include with your complaint.

We are prohibited by law from giving legal advice. As a result, our office cannot provide legal advice, interpretation, or individual representation. To preserve any legal rights you may have, you may wish to consult with a private attorney and/or review the possibility of small claims court remedies.

About You

Your Name (please enter your full name, ex: John Smith): *

Your Address: *

City: *

Zip: *

State: *

Home Phone: *

Business Phone:

Email: *

Are you over 60 years of age?:

Yes

This information is collected for statistical purposes only.

About the Company you are Complaining Against

Name of the Company: *

Company Address: *

City: *

State: *

Zip: *

Phone: *

Email:

Web Site:

Name of Sales Person or Principal of Business:

Your Complaint

Have you discussed the complaint with the owner or manager of the business?: *

Yes

Name of the person with whom you spoke:

When did you speak with this person?:

Type of Product or Service: *

Date Purchased: *

Order, Contract, Account or Policy #:

Was the product or service advertised?: *

Yes

Where?:

When?:

Describe any representations made about the product or service : *

Your Complaint: *

Briefly explain the nature of your complaint. Please be clear, concise, accurate, and eliminate biases and opinions. If there is further relevant information, please attach a separate sheet.

What do you consider to be a fair resolution to seek from the business?: *

Amount of Loss

Amount in Dispute: * $ (Actual loss only)

Please include only numbers, for example, if the amount is $28,000 enter 28000

Consumer Fraud Awareness

By submitting this complaint electronically, I hereby certify I am the above listed individual and authorize the above listed business and/or its agents to discuss the details of my complaint with representatives of the Colorado Attorney General’s Office. I verify I have read the preceding information and it is true to the best of my knowledge.

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