Office of the Louisiana Attorney General - James D. "Buddy" Caldwell

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Programs

Consumer Complaint Form

Required Fields appear as
Complaint Date: 2/9/2010
Your Information
	Are you over the Age of 60?
	Your Full Name:
	Mailing Address:
	City,Sate/Zip:
	Telephone:	or
	Incident Address Same as Mailing Address
	Incident Address:
	City,Sate/Zip:
	Parish:
Company Information
	Person Complained Against:
	Company Name:
	Address:
	City,Sate/Zip:
	Telephone:
Complaint Information
	Date of Transaction:
	Date Contacted Company:
	Description:
	Manufacturer:
	Purchase:
AFTER REVIEWING YOUR COMPLAINT AND THE STEPS YOU HAVE TAKEN TO RESOLVE IT, YOU MAY BE REFERRED TO ANOTHER AGENCY, A PRIVATE ATTORNEY, SMALL CLAIMS COURT OR JUSTICE OF THE PEACE COURT, OR SOME OTHER METHOD OF RESOLVING YOUR COMPLAINT. A COPY OF THIS COMPLAINT MAY BE SENT TO THE BUSINESS COMPLAINED AGAINST.
	Full Complaint:
	What would Satisfy your Complaint?
PLEASE READ THE FOLLOWING CAREFULLY. By submitting this form, you are signifying that you have read and understand the following statements: I understand the Attorney General's Office may provide copies of this form and any attachments to the business complained about and other private and public agencies. I authorize the Office of the Attorney General to give copies or any information of the form toanyone deemed necessary by them. I understand that the Attorney General's office is not my legal representative. I understand that it is recommended that I consult a private attorney. I also understand that I may lose my private right to sue about this matter entirely if I wait too long to do so. I also understand that any action by the Attorney General's office may not result in a refund or other relief for mepersonally. I wish to file this complaint with the Attorney General's office. I understand that your office does not conduct litigation for individuals in matters which involve purely private controversies. I am, however, filing this complaint to notify your office of the activities of this party and to seek any other assistance you may be able to render. I understand and agree to all above conditions.



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