Department Complaint Form - Rhode Island Department Of Business Regulation Page 2

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NATURE OF COMPLAINT: If more space is needed attach additional sheets.
The Department will investigate your complaint for possible violations of applicable statutes and
regulation. We will make every effort to bring about a satisfactory resolution---this Department only has
jurisdiction to take certain statutorily defined regulatory actions against the regulated entity/individual. The
Department does not have jurisdiction to order the entity/individual against whom you are filing this complaint
to return or refund money to you. Therefore, occasionally, a resolution may not lie within the jurisdiction of this
Department. If that is the case, we may suggest you seek an attorney, or refer you to an appropriate agency. If
your complaint involves securities, you may also wish to seek arbitration through the National Association of
Securities Dealers, Inc. c/o Arbitration Committee, 33 Whitehall Street, New York, NY 10004, (212) 858-
4400.
08/05

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