Consumer Complaint Form

Before completing this form, please take a moment to read this guide.

If you believe you have been the victim of consumer fraud, complete the online form below.

For more information you can contact us by phone at (602) 542-5763 (Phoenix), (520) 628-6504 (Tucson), or toll free outside metro Phoenix, (800) 352-8431, or by email at consumerinfo@azag.gov. Please provide your supporting documents by fax at (602) 542-4579 or by mail at 1275 West Washington Attn: Consumer Information and Complaints, Phoenix, AZ 85007 and include your name and complaint number if available.

If you'd like to submit your complaint through the mail, please click here to download the form. Be sure to mail copies of your supporting documents along with the complaint form.

Your Information

Full Name:

Street Address:

City:

State:

Zip Code:

Best Number to Call During Day:

Phone:

E-mail Address: *

Party or Firm You Are Complaining Against

Name: *

Street Address:

City:

State:

Zip Code:

Phone:

E-mail Address:

Website Address:

May we send a copy of this to the person or business you are complaining against?

(By selecting the answer, “Yes", to the question, “May we send a copy of this to the person or business you are complaining against,” I hereby authorize the Office of the Arizona Attorney General to communicate with the party(ies) against whom I have filed this complaint. I also authorize the party(ies) against whom I have filed this complaint to communicate with and provide information related to my complaint, including disclosure of non-public personal information, to the Office of the Arizona Attorney General in connection with this complaint. If your response is "no", we may be prevented from taking any action on your complaint.)

Please explain the entire circumstances surrounding your complaint below:

Please fully describe any oral or written misrepresentations made to you.

Have you complained to the firm/agency/business?

What was their response?

Was an oral or written warranty given?

Did you sign any documents?

Date of Transaction:

Month

Day

Year

Place of Transaction:

(Examples: home, store, internet)

Total Amount of Damages:

(List actual loss only.)

Salesperson's Name:

Witness to Transaction:

Was the product or service advertised?

If yes, indicate the date and how it was advertised:

Do you have an attorney?

If yes, please provide the attorney's name and address:

Is any legal action pending?

List any other consumer agencies contacted:

May we provide your name and telephone number to the media in the event of an inquiry about this matter?

May we send a copy of your complaint to another government agency for their review or investigation?

Additional Comments:

For statistical purposes, please indicate:

Your Age:

Military/Veteran Status:

How did you hear about our complaint form (please choose only one):

Declaration: I declare under penalty of perjury, that the facts and statements contained in this declaration, including any attached statements, are true, correct, and based upon my personal knowledge. I understand that the information contained in this declaration can only be altered by submitting a new declaration. By choosing to submit this form electronically, I certify and agree that by entering my name in the space below, I bind and legally obligate myself to the same extent as I would by signing my name on a printed paper version of this form.

Declaration 2: *

Please type full name to act as signature.

Date: *

Arizona Attorney General

Mark Brnovich

Your Information

Party or Firm You Are Complaining Against

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Consumer Complaint Form

Your Information

Party or Firm You Are Complaining Against