General Consumer Complaint and Dispute Form

This is UCAN's general consumer complaint form for CALIFORNIA RESIDENTS ONLY [1]. Need help resolving a dispute with a company? Get personal help with your dispute from the Fraud Squad by filling out the form below [2]!

If you want to make a complaint regarding your telecommunications services (phone, wireless phone) please use our Telephone Bill Complaint Form [3].

Remember, if you are a member [4], you always move to the front of the line in the complaint process, and you always get priority treatment. If you are not a member of UCAN, but live in California, we may still be able to assist you, but cannot guarantee assistance due to our limited staff. If we cannot assist you directly, we will do our best to get you in touch with someone who can help you. Keep in mind, we have an excellent record of helping all California consumers.

Email: *

First Name: *

Last Name: *

ADDRESS

Your Mailing Address: *

City: *

State: *

Zip Code: *

Phone: *

Best Way We Can Contact You Between 9-5 Monday-Friday:

Are You A UCAN Member?: *

Would you be willing to speak to a sympathetic reporter about your situation?:

Do you give UCAN permission to discuss your acct. with the company in question?:

Type of complaint::

Name of the company(s) involved in dispute::

Company phone number::

Account Number if Applicable::

Are you filing this complaint on behalf of your business?:

If yes, what is the name of your business?:

How much money are you disputing?:

Please explain the nature of your dispute and how you think it can be resolved to your satisfaction::

What have you done thus far to resolve the problem?:

What have you done thus far to resolve the problem? When did the problem first come to your attention and who have you contacted at the company? Give us what you think we need to know to intervene on your behalf (Please include names, title, agency or company and phone number or email addresses where appropriate).

Do you have any pertinent documents, such as bills, contracts or dispute letters regarding the situation?:

If so, please attach relevant documents below. You can also send documents via fax at 619-696-7477, or directly through email to complaintforms [at] ucan [dot] org or by mail to UCAN 3100 5^th ave, Ste. B San Diego, CA 92103.

Attach your documents here:

Please include any additional information not covered in this intake form here.:

Would you like to share your story with others here on our website?: *

Yes

Remember, no personally identifiable information will be disclosed on the website without your consent

If yes, please include a description of your problem to be shared with others below:

Note, if you would like to share your story, and leave this box blank, we will use the information provided above.

Links:
[1] http://www.ucan.org/drupal/takeaction/file_a_complaint/general_consumer_complaint_dispute_form%2523form
[2] http://www.ucan.org/drupal/takeaction/file_a_complaint/general_consumer_complaint_dispute_form%2523form
[3] http://www.ucan.org/drupal/takeaction/file_a_complaint/telephone_bill_complaint_form
[4] https://interland3.donorperfect.net/weblink/weblink.aspx?name=ucan&id=1
[5] http://www.ucan.org/drupal/drupal/takeaction/file_a_consumer_complaint
[6] http://www.ucan.org/drupal/drupal/takeaction/file_a_consumer_complaint
[7] http://www.ucan.org/drupal/drupal/takeaction/file_a_complaint/telephone_bill_complaint_form