General Complaint Form

If you would prefer to file your complaint by mail, click here for instructions for using our printed complaint forms.
Please capitalize the first letter of the consumer's name and address and the business's name and address.
CONSUMER INFORMATION
Please complete the following information about the consumer involved in this dispute.
* Denotes Required Fields

*Last Name:
*First Name:
*Prefix (e.g. Mr., Mrs., Ms., Miss):
*Address:
Address 2 (if necessary):
*City:
*State:
*Zip Code:
*Best Telephone Number To Use During the Day:
Alternate Telephone Number :
E-mail Address:
Please enter only the primary e-mail address at which you would like us to contact you. Please type your address carefully with no extra spaces or characters. An incorrect e-mail address may delay action on your complaint.
If someone other than the consumer should be contacted about this complaint, please provide the name and telephone number of the contact person:
How did you hear about our office?

BUSINESS INFORMATION
Please complete the following information about the business against which you are filing this complaint.

*Business Name:
*Address (Please note: in order to assist you, it is important for us to have the full address of the business. If you are not able to provide the business' address please write "unknown"):
Address 2 (if necessary):
*City:
*State:
*Zip Code:
*Primary Telephone Number (Please note: in order to assist you, it is important for us to have the telephone number of the business. If you are not able to provide the business' telephone number, please write "unknown"):
Alternate Telephone Number:
Fax Number:
E-Mail Address:
Web Site Address:

Information About the Transaction Involved in this Dispute:

*Please describe your dispute. Be sure to include important specifics such as dates, names of relevant people, and the amounts of any monies charged or paid:
When did the purchase or lease of consumer goods or services take place? If there was no purchase or lease, please leave this field blank. Use mm/dd/yyyy format:
How did you hear about the business?
Where did the purchase or lease of consumer goods or services take place?
How much did you pay? $
How did you pay?
*What would you like the business to do to resolve your complaint?
If "Other", please describe:
If "Refund", please state the amount desired: $
*Do you have any documents that support your complaint? It is important to provide us with copies of any documents that support your complaint (such as contracts, warranties, receipts, or repair invoices.)noyes
Please list the types of documents you have that support your complaint here (such as contracts, warranties, receipts, or repair invoices) and send us a copy (no originals, please) of those documents, following the instructions at the end of this form.:

Steps You've Taken to Resolve Your Complaint:

Most recent date on which you contacted the business about your complaint: Use mm/dd/yyyy format:
Name of the person to whom you complained:
Have you filed a complaint with any other government agency? noyes
If yes, which agency?
Have you contacted an attorney or filed a lawsuit in this matter? noyes

Please note that while you may file a complaint for informational purposes with this office in addition to filing a lawsuit, we cannot represent you or provide legal advice on your lawsuit.
Instructions for Completing your Complaint:
1. Review the information you have provided above and make any needed corrections.
2. Click the Submit button below.
3. Print two copies of the Confirmation page.
4. Mail a copy of the Confirmation page (all pages please) along with any supporting documents.
Please remember that it is important for us to have copies of all relevant documents to properly handle your complaint. If you have any documents that support this complaint (such as contracts, warranties, receipts, repair invoices, etc.), please mail a copy of those documents (no originals) to the Consumer Protection Division. Once your documents are received, we will proceed with processing your complaint.
* Denotes Required Fields

If you experience a problem while trying to submit your complaint, you may contact our office at 410-528-8662, Monday through Friday from 9:00 a.m. to 3:00 p.m. or send an e-mail describing the problem to: consumer@oag.state.md.us You will receive a response during regular business hours.