Consumer Complaint Form
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1
2Send to:
State of Utah
Utah Division of Consumer Protection
Attention: Complaint Processor
nd
Heber M. Wells Building, 2
Floor
Department of Commerce
160 East 300 South, SM Box 146704
Division of Consumer Protection
Salt Lake City, UT 84114-6704
(801) 530-6601 | (801) 530-6001 fax
Consumer Complaint Form
The Division of Consumer Protection is charged with enforcing consumer protection laws. We offer assistance according
to those laws; however, you should not rely solely on the filing of this complaint to resolve your problem. You may need
to consult an attorney to determine what remedies may be available to you and any statute of limitations that may apply to
your case.
CONSUMER INFORMATION
Your Name
Home telephone number
Daytime or Work telephone
Street Address
City
State
Zip Code
E-mail Address
COMPLAINT AGAINST
Name of Business Entity
Daytime telephone number
Other telephone or facsimile
Street Address
City
State
Zip Code
E-mail Address
Web Address (URL)
TRANSACTION INFORMATION
Amount of Transaction
Date of Transaction
Method of payment for transaction
Did you enter into a contract with the supplier (including verbally, in writing, over the telephone, etc.)? If yes, give location and date.
NO
YES
Was the product or service advertised? If yes, give location and date.
NO
YES
How would you like to see your complaint resolved?
OTHER INFORMATION
Has this matter been submitted to another government agency, an arbitration service, or to an attorney? If yes, give name, address, and telephone
number. If a court action has been filed, include name of court, address, and case number.
NO
YES
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Parent category: Legal