Complaint Form
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3Mississippi
State Board of Contractors
JOHN M. SULLIVAN, II
Executive Director
______________________________________________________________________________
COMPLAINT FORM
______________________________________________________________________________
Miss. Code Ann. §73-59-13(2) provides that the Board shall investigate all charges filed with it and, upon finding reasonable cause to believe that
the charges are not frivolous, unfounded or filed in bad faith, may, in its discretion, cause a hearing to be held at a time and place fixed by the
Board regarding the charge. Please pay careful attention when completing this form. Include in your complaint everything you want to have
considered by the Mississippi State Board of Contractors. We can assist you more efficiently if your form is completed correctly. Complete all
sections and be as specific as possible. List the actual problems and the reason for your complaint. Additional pages may be attached if
necessary. The complaint form must be signed. Unsigned complaint forms will not be considered by the Board. Note: Investigations by
MSBOC does not guarantee restitution to complainants. If your primary interest is to gain restitution, you should consult an attorney and/or
pursue litigation.
COMPLAINANT
COMPLAINT AGAINST
________________________________________________
________________________________________________
Last
First
Middle
Last
First
Middle
________________________________________________
________________________________________________
Company Name
Company Name
________________________________________________
________________________________________________
Mailing Address
Mailing Address
________________________________________________
________________________________________________
City
State
Zip
City
State
Zip
________________________________________________
________________________________________________
Telephone #
Alternate Phone #
Telephone #
Alternate phone
Basis for Complaint:
RESIDENTIAL
COMMERCIAL
___ UNLICENSED RESIDENTIAL BUILDER
___ UNLICENSED COMMERCIAL CONTRACTOR
___ UNLICENSED RESIDENTIAL REMODELER
___ IRRESPONSIBLE
___ FAILURE TO PAY FOR GOODS OR SERVICES
___ FAILURE TO PAY FOR GOODS OR SERVICES
___ FAILURE TO VERIFY COR
___ OTHER ________________________________
___ GROSS NEGLIGENCE OR MISCONDUCT
Post Office Box 320279 · Jackson, MS 39232-0279 · 2679 Crane Ridge Dr., Suite C · Jackson, MS 39216 · 601-354-6161 · Fax 601-354-6715
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