Collection Agency Regulation: Complaint Form

Consumer Name*
Address*
City*
State*
Zip/Postal Code*
Email*
Phone*
Military Veteran Status*
Are you an active or retired member of the U.S. Armed Forces or a dependent?
- Yes
- No
Branch
Military Status

Business Name*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email
Phone
Website
Type of Business*
Other

If other business type, please provide a brief description.
Type of Debt*
Other

If other, please provide a brief description.

Summary of Complaint*
Related Documents*
- Yes
- No
In order to ensure a timely investigation of your complaint, please include a copy of your loan agreement or contract along with any and all correspondence you had with the business. DO NOT SEND ORIGINAL DOCUMENTATION.
Upload Files
Drop files here or

Max. file size: 8 MB.
By submitting this complaint electronically, I hereby certify I am the above listed individual and authorize the above listed business and/or its agents to discuss the details of my complaint with representatives of the Colorado Attorney General's Office. I verify I have read the preceding information and it is true to the best of my knowledge.
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