Consumer Complaint Form Office Of The Attorney General Consumer Protection Division printable pdf download

Consumer Complaint Form Office Of The Attorney General Consumer Protection Division

CONSUMER COMPLAINT FORM

OFFICE OF THE ATTORNEY GENERAL

CONSUMER PROTECTION DIVISION

File your complaint online at

https://fortress.wa.gov/atg/formhandler/ago/ComplaintForm.aspx

for faster

processing. The Washington State Office of the Attorney General can only process complaints that involve either

Washington state residents or businesses located in Washington state. Information marked with * is required.

I. CONSUMER INFORMATION

* Last Name:

* First Name:

Middle Initial:

* Address:

* City:

*State

*Zip

* Contact Phone: (

)

Alternate Phone: (

)

* E-Mail Address:

Are you a member or former member of the U.S. Armed Forces, Guard, Reserves or a dependent?

(Optional):

YES

If English is not your first language, what is your first language? (Optional):

For our statistics, please select your age group (Optional):

18-29

30-39

40-49

50-59

59+

Under 18

II. ABOUT YOUR COMPLAINT

* Business Name:

* Address:

* City:

*State

*Zip

* Business Phone: (

)

E-Mail:

Website:

Names/addresses/phone numbers of other businesses involved in your complaint:

Transaction date:

Amount in dispute: $

State your complaint and how you think this complaint can be resolved:

CONSUMER COMPLAINT PAGE 1 OF 2

Consumer Complaint Form Office Of The Attorney General Consumer Protection Division

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