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COMPLAINT FORM

 

 

 

 

 

Better Business Bureau serving Alaska, Oregon & Western Washington

 

 

 

 

Your privacy is important to us. Our privacy policy can be found at www.bbb.org or by contacting us.

 

 

With Trust

Your Better Business Bureau recommends filing your complaint online at www.bbb.org.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IMPORTANT: COMPLETE ALL FOUR SECTIONS

 

 

 

COMPANY NAME

 

CONSUMER NAME

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPANY ADDRESS, CITY, STATE, ZIP

CONSUMER ADDRESS, CITY, STATE, ZIP

 

 

 

 

 

 

 

 

 

COMPANY EMAIL

 

CONSUMER EMAIL

 

 

 

 

 

 

 

 

 

 

COMPANY PHONE #

 

CONSUMER HOME PHONE #

 

CONSUMER WORK PHONE #

 

 

 

 

 

 

 

 

 

2

DATE PROBLEM OCCURRED

 

DATE(S) YOU COMPLAINED TO

 

TO WHOM:

 

 

 

 

CO.

 

 

 

 

 

 

 

 

 

 

 

 

PRODUCT/SERVICE

 

BRAND NAME

 

MODEL NAME OR NO.

 

 

 

 

 

 

 

 

ORDER, CONTRACT, ACCOUNT # (if applicable)

IF ADVERTISING INVOLVED, WHERE/WHEN

 

 

 

 

 

 

 

 

AMOUNT INVOLVED

 

NAME OF SALESPERSON

 

 

$:

 

 

 

 

 

 

 

3

WHAT IS YOUR COMPLAINT? If you have any relevant documents such as contracts, receipts, or cancelled checks, please include a copy.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

WHAT IS THE EXACT ADJUSTMENT YOU ARE REQUESTING FROM THE COMPANY?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TO THE CUSTOMER: MAIL THIS

 

 

 

 

 

 

COMPLETED AND SIGNED FORM

CUSTOMER SIGNATURE

 

 

 

BACK TO YOUR BBB. YOUR

 

 

 

 

 

 

SIGNATURE GIVES BBB

 

 

 

 

 

 

 

 

 

 

 

 

PERMISSION TO RELEASE THIS

DATE

 

 

 

 

 

INFORMATION TO REGULATORY

 

 

 

 

 

 

 

 

 

 

 

AUTHORITIES AS NECESSARY.

 

 

 

 

 

P.O.Box 1000 DuPont, WA 98327

Alaska: (907)562-0704 Oregon: (503)212-3022 Washington: (206)431-2222 or (253)830-2924 Fax: (206)431-2200

The text of your complaint will be publicly posted on the BBB Website (BBB reserves the right to not post in accordance with BBB policy). Please do not include any personally identifiable information in describing the nature of your complaint. By submitting your complaint, you are representing that it is a truthful account of your experience with the business. BBB may edit your complaint to protect privacy rights and to remove inappropriate language.

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