Louisiana Real Estate Appraisers Board Post Office Box
ADVERTISEMENT
1LOUISIANA REAL ESTATE COMMISSION AND
LOUISIANA REAL ESTATE APPRAISERS BOARD
POST OFFICE BOX 14785
BATON ROUGE, LOUISIANA 70898
TOLL FREE 1-800-821-4529 (In State Only)
(225) 765-0191, Ext. 233
COMPLAINT FORM
______________________________________________
YOUR NAME
FOR OFFICE USE ONLY
_________________
_________________________________________________
ADDRESS
INVESTIGATOR
_________________
City
State
_______________________
_______________________
PHONE:
DATE ASSIGNED
Home
Office
I WISH TO FILE A COMPLAINT AGAINST THE FOLLOWING LICENSEE(S), REGISTRANT(S) OR
CERTIFICATE HOLDER(S), FOR WHAT I FEEL IS A VIOLATION OF THE LOUISIANA REAL ESTATE
LICENSING LAW OR THE LOUISIANA CERTIFIED REAL ESTATE APPRAISERS LAW. I UNDERSTAND
THAT IN MAKING THIS COMPLAINT, I AM SUBJECTING THAT PERSON TO THE POSSIBLE
SUSPENSION OR REVOCATION OF HIS/HER LICENSE, REGISTRATION, OR CERTIFICATE. I
FURTHER DECLARE THAT THIS COMPLAINT IS MADE IN GOOD FAITH AND THAT IF A HEARING IS
HELD IN THIS MATTER, I WILL BE AVAILABLE TO TESTIFY.
_____________________________________________________________________________________
AGAINST WHOM IS THIS COMPLAINT BEING FILED?
_____________________________________________________________________________________
COMPANY BUSINESS PHONE
COMPANY ADDRESS
CITY
STATE
(PLEASE STATE YOUR COMPLAINT AND ENCLOSE COPIES OF ANY PERTINENT DOCUMENTS.)
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
(Please use back of form if additional space is necessary)
I REALIZE THAT THE COMMISSION AND THE BOARD CANNOT ENTER INTO ANY CIVIL ACTION ON
MY BEHALF, AND THAT THEIR SOLE JURISDICTION IS OVER THE LICENSE, REGISTRATION, OR
CERTIFICATION OF THE RESPONDENT(S) NAMED IN THIS COMPLAINT.
___________________________________
__________________________________
PLEASE SIGN YOUR NAME
DATE
* We do not accept faxed complaint forms. Please mail completed form with an original signature to ensure prompt attention.
* We do not accept faxed complaint forms. Please mail completed form with an original signature to ensure prompt attention.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Life