Talk To Us - Complaint Form

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This form is available for you to send a complaint to the Federal Trade Commission concerning a particular company or organization. Although the Commission cannot resolve individual problems for consumers, it can act against a company if it sees a pattern of possible law violations. Remember, we may share the information you provide with others. Read the Talk to Us page for more information.

Please do not include in this electronic complaint form any personal information like your bank account, charge card, or social security number. If you must include that information in your complaint, please send it to us by postal mail instead.

If you would like to forward unsolicited commercial e-mail (spam) to the Commission, please send it directly to UCE@FTC.GOV without using this form.

How Do We Reach You?

First Name:

Last Name:

Street Address:

City:

State or
Canadian Province:
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Country:
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Zip Code or
Postal Code:

E-Mail Address:

Home Phone:
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Work Phone: Ext.
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Tell Us Your Complaint...

Subject of Your Complaint:
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Name of Company You Are Complaining About:

Street Address:

City:

State or
Canadian Province:
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Country:
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Zip Code or
Postal Code:

Company Web Site:

Company E-Mail Address:

Phone Number: Ext.
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How Did the Company Initially Contact You?
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How Much Did the Company Ask You To Pay?
$

How Much Did You Actually Pay the Company?
$

How Did You Pay the Company?
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Representative or Salesperson

First Name

Last Name:

Date Company Contacted You :
(MM/DD/YYYY)

Explain Your Problem: Please limit your entry to 2,000 characters (approx. 30 lines)

Last Updated: Wednesday, August 04, 1999