Contact Consumer Affairs

Please be advised, the more information you can provide, will help us with the investigation. Thank you.

Name of Contractor	*
Address
City, State, Zip
Individuals Name
Date of Offense	*
Time	*
Location of work being performed	*
Address	*
City, State, Zip	*
Type of work being performed	*
Additional Comments
Plate Numbers
Your Name
Your Phone
Your Email Address
Security Question:	*	What is 3+3 ?
		* Indicates required fields