Consumer Dispute Form

Your Information

Incident Information

Company Information

Complaint Information

After reviewing your dispute 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 dispute. A copy of this dispute may be sent to the business disputed against.

PLEASE READ THE FOLLOWING CAREFULLY. By submitting this form, you are signifying that you have read and understand the following statements:

Any and all attachments need to be mailed to:

PO Box 94005
Baton Rouge, LA 70804

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 to anyone 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 me personally.

I wish to file this dispute 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 dispute to notify your office of the activities of this party and to seek any other assistance you may be able to render.

Coming soon, the attorney's general office seeks to provide a mechanism by which to take online payments for collections.