Complaint Input Form

Use this form to submit a complaint to the Federal Trade Commission (FTC) Bureau of Consumer Protection about a particular company or organization. This form also may be used to submit a complaint to the FTC concerning media violence. The information you provide is up to you. However, if you do not provide your name or other information, it may be impossible for us to refer, respond to, or investigate your complaint or request. To learn how we use the information you provide, please read our Privacy Policy.

While the FTC does not resolve individual consumer problems, your complaint helps us investigate fraud, and can lead to law enforcement action. The FTC enters Internet, telemarketing, identity theft and other fraud-related complaints into Consumer Sentinel®, a secure, online database available to hundreds of civil and criminal law enforcement agencies worldwide.

We use secure socket layer (SSL) encryption to protect the transmission of the information you submit to us when you use our secure online forms. The information you provide to us is stored securely.

IMPORTANT:
* If you want to file a complaint about a violation of National Do Not Call Registry or register your telephone number on the Registry, Please go to www.donotcall.gov
* If you want to file a report about Identity Theft, please use our Identity Theft Complaint Form.
* If you want to file a complaint about an online transaction that involves a foreign company, please use our econsumer.gov complaint form.

If you have a specific complaint about unsolicited commercial e-mail (spam), use the form below. You can forward spam directly to the Commission at SPAM@UCE.GOV without using the complaint form.

How Do We Reach You?

First Name:
Last Name:
Age Range:"Click" Arrow for Choices
Street Address:
City:
State or Canadian Province:"Click" Arrow for Choices
Country:"Click" Arrow for Choices
Zip Code or Postal Code:
E-Mail Address:
Home Phone:()(Area Code)(Phone Number)
(Numbers Only)
Work Phone:()Ext.(Area Code)(Phone Number)(Extension)
(Numbers Only)
Social Security Number:--Enter Only For Complaints Relating to the Accuracy of Your Credit Report
(Numbers Only)

Tell Us Your Complaint...

Subject of Your Complaint:"Click" Arrow for Choices
Name of Company You Are Complaining About:
Check If Company Name Is Unknown:
Street Address:
City:
State or Canadian Province:"Click" Arrow for Choices
Country:"Click" Arrow for Choices
Zip Code or Postal Code:
Company Web Site:
Company E-Mail Address:
Phone Number:()Ext.(Area Code)(Phone Number)(Extension)
(Numbers Only)
How Did the Company Initially Contact You?"Click" Arrow for Choices
How Much Did the Company Ask You to Pay?(Numbers Only)
How Much Did You Actually Pay the Company?(Numbers Only)
How Did You Pay the Company?"Click" Arrow for Choices
Did You File a Dispute with the Credit Bureau?"Click" Arrow for Choices
Did You File a Dispute with the Credit Bureau More Than 45 Days Ago?"Click" Arrow for Choices

REPRESENTATIVE OR SALESPERSON
First Name:



Last Name:
Date Company Contacted You: (MM/DD/YYYY)
Explain Your Problem: (Please limit your complaint to 2000 characters.):

Paperwork Reduction Statement: This form is designed to improve public access to the FTC Bureau of Consumer Protection Consumer Response Center, and is voluntary. Through this form, consumers may electronically register a complaint with the FTC. We estimate that it will take, on average, 5 minutes to complete the form. Under the Paperwork Reduction Act, as amended, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. That number is 3084-0047, which also appears in the upper right-hand corner of the first page of this form