Free Bbb Complaint PDF Form
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Preview - Bbb Complaint Form
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COMPLAINT FORM |
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Better Business Bureau serving Alaska, Oregon & Western Washington |
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Your privacy is important to us. Our privacy policy can be found at www.bbb.org or by contacting us. |
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With Trust |
Your Better Business Bureau recommends filing your complaint online at www.bbb.org. |
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IMPORTANT: COMPLETE ALL FOUR SECTIONS |
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COMPANY NAME |
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CONSUMER NAME |
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1 |
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COMPANY ADDRESS, CITY, STATE, ZIP |
CONSUMER ADDRESS, CITY, STATE, ZIP |
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COMPANY EMAIL |
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CONSUMER EMAIL |
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COMPANY PHONE # |
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CONSUMER HOME PHONE # |
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CONSUMER WORK PHONE # |
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2 |
DATE PROBLEM OCCURRED |
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DATE(S) YOU COMPLAINED TO |
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TO WHOM: |
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CO. |
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PRODUCT/SERVICE |
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BRAND NAME |
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MODEL NAME OR NO. |
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ORDER, CONTRACT, ACCOUNT # (if applicable) |
IF ADVERTISING INVOLVED, WHERE/WHEN |
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AMOUNT INVOLVED |
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NAME OF SALESPERSON |
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$: |
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3 |
WHAT IS YOUR COMPLAINT? If you have any relevant documents such as contracts, receipts, or cancelled checks, please include a copy. |
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4 |
WHAT IS THE EXACT ADJUSTMENT YOU ARE REQUESTING FROM THE COMPANY? |
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TO THE CUSTOMER: MAIL THIS |
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COMPLETED AND SIGNED FORM |
CUSTOMER SIGNATURE |
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BACK TO YOUR BBB. YOUR |
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SIGNATURE GIVES BBB |
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PERMISSION TO RELEASE THIS |
DATE |
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INFORMATION TO REGULATORY |
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AUTHORITIES AS NECESSARY. |
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P.O.Box 1000 DuPont, WA 98327
Alaska:
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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