Consumer Gasoline Price Complaint - Office Of Arizona Attorney General Form

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Office of Arizona Attorney General
Mark Brnovich
Consumer Gasoline Price Complaint Form
Consumer’s Information
Gasoline Station’s Information
Name:
Name:
Address:
Address:
City:
City:
State:
State:
Zip:
Zip:
Phone:
Phone:
Details of Purchase
Grade of Gasoline Purchased:
Price per Gallon Paid:
Total Amount of Purchase:
Date of Purchase:
Time of Purchase:
Comments:
1275 West Washington Street, Phoenix, AZ 85007

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