Tenant Harassment Complaint Form
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Complete Tenant Harassment Complaint Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
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2
3
4Consumer Hotline
Consumer Frauds and Protection Bureau 120
rd
(800) 771-7755
Broadway, 3
Floor
TDD (800) 788-9898
New York, NY 10271
Phone: (212) 416-8300 Fax: (212) 416-8787
Para español llame: (212) 416-8342
1. Please be sure to complain to the landlord or management company before filing a complaint.
2. Please type or print clearly in dark ink. Form may also be filled in online using Adobe Acrobat version 5.0
(or later) and printed out for mailing.
3. Complete the entire form. Incomplete or unclear forms will be returned to you.
4. Please attach photocopies—no originals—of supporting documents.
Please complete this form only if your attempt to resolve your complaint with the landlord has been unsuccessful. Each tenant should
submit a separate complaint form. You may duplicate this form or obtain additional copies from our office.
TENANT INFORMATION
Name
Home phone
Business phone
Street Address (Current)
Apt. No.
Email address
City/Town
County
State
Zip
Address of Apartment Involved (if different from current address)
Street Address
Apt. No.
City/Town
County
State
Zip
TO WHOM DO YOU PAY RENT?
Name
Phone (if known)
Email address (if known)
Street Address (if known)
Website (if known)
City/Town
County
State
Zip
LANDLORD INFORMATION
Former or Current Landlord Involved in This Complaint
Phone (if known)
Email address (if known)
Street Address (if known)
Website (if known)
City/Town
County
State
Zip
CFB001 - (rev. 12/16)
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Parent category: Legal