Before you press the "Submit" button, please
print a copy of the completed Consumer
Complaint Form for your records. If you have supporting documentation regarding
your complaint such as contracts, warranties, bills received, canceled checks, correspondence,
etc., please mail or fax copies of these documents as well as a copy of the completed
Consumer Complaint Form to the address at the bottom of this screen. DO NOT SEND
PLEASE READ THE FOLLOWING BEFORE SUBMITTING THIS FORM
In filing this form, I understand that the Division of Consumer Protection (DCP) is attempting to mediate my complaint.
I also understand that if I have any questions concerning my legal rights or responsibilities,
I should contact a private attorney. I hereby authorize the DCP to work with the
appropriate government and private sector entities on my behalf, including requesting
and reviewing appropriate documents, to attempt to resolve my dispute. I have no
objection to the contents of this complaint being forwarded to the business or service
person the complaint is directed against. The above complaint is true and accurate
to the best of my knowledge.
This document is subject to disclosure under the Freedom of Information Law. The person or firm you are complaining about may receive a copy of this complaint.
New York State Department of State
Division of Consumer Protection
Consumer Assistance Unit
99 Washington Avenue
Albany, New York 12231-0001