Complaint and Inquiry Form Step 1 of 3 - Complaint Detail 0% Complaint DetailSelect the option that best fits your complaint or inquiry*Unemployment FraudAssociations, Charities, and Non-ProfitsAutomobiles and Related Services (ex. Purchases, Repair)Health and Medical ServicesHome Services and Repair (ex. Contractors, Home Building, Electricians, Plumbers, Roofers)Moving (ex. Moving within Colorado and across the United States)Real Estate Sales and Services (ex. Agents, Brokers, Rentals and Leasing)Retail Sales and Related ServicesScams and Telephone CallsTelecommunications (ex. Cable, Internet, and Phone)Vacation and Travel (ex. Airlines, Lodging, Travel Agencies)Something ElsePlease select the type of Unemployment Fraud you are reportingI received a ReliaCard in my nameI received one or more ReliCard's in someone else's nameI received a 1099G or other related tax documentMy employer notified me a fraudulent claim had been filed in my nameMy identity was otherwise used to file an unemployment claimSomething ElsePlease select the type of Association, Charity, or Non-Profit you are reportingBusiness Affiliation Groups and Industry AssociationsCivic, Social, and Fraternal AssociationsEmergency and Other Relief ServicesEnvironment, Conservation, Domestic Animals, and WildlifeHuman Rights and Advocacy OrganizationsPollical Organizations and Related ServicesReligious OrganizationsOtherPlease select the type of Automobiles and Related Services you are reportingFinancing, Leasing, and InsurancePurchasesParts, Accessories, and Tire StoresRentalsService and Repair (ex. Mechanic and service shop)OtherHow was your purchase made?Please select if you purchase involved a dealership or an individual.DealershipIndividualPlease select the type of Health and Medical Services you are reportingAlternative MedicineAmbulance ServicesBillingDentistryHealth InsuranceHealth Practitioners (ex. Doctors, Chiropractors, Nursing, Specialty Medicine, Surgeons)Home Health Care Agencies and Related ServicesHospitals and Urgent CareHospice and Nursing Care FacilitiesMental Health PractitionersNon-Emergency Medical TransportPharmaceutical Sales and ServiceOtherPlease select the type of Home Services and Repair you are reportingCommercial or Residential Home BuilderExtermination and Pest ControlLawn and Landscaping ServicesSecurity Systems and Related ServicesSpecialty Trade Contractors (ex. Contractors, Doors and Windows, Handyman Services, Painting, Plumbing)Waste Management and Remediation ServicesOtherPlease select the type of Real Estate Sales and Services you are reportingAgents and BrokersAppraisersBuilding and Home Inspection ServicesMobile Homes and Mobile Home ParksRentals and LeasingOtherPlease select the type of Telecommunications issue you are reportingBundled ServicesCable / Satellite TelevisionCellular and Mobile CommunicationsInternet ServicesOtherPlease select the type of Vacation and Travel Services you are reportingAirlinesCruise LinesHotelShort Term Home Stay and Lodging Rentals (ex. Airbnb, VRBO)TimesharesTravel AgenciesTravel Arrangement and Reservation Services (ex. Expedia, Kayak, Priceline)Tour Operators and ServicesOtherWhat type of Scam are you reporting?Billing / InvoiceBusiness Opportunities and Pyramid SchemesCharitable SolicitationsCOVID-19Employment and Job ScamsFinancial Scams (ex. Debt Collection, Grant Scams, Loans, Investments)Health and MedicalHousing and RentalsImposter ScamsPet Sales and ServicesSurveysSweepstakes and LotteriesTech Support (ex. Microsoft Technical Support)Timeshare and TravelUnemploymentOtherHow did you first learn about this?Telephone CallEmailDoor-to-DoorE-Commerce and Classified Sites (ex. eBay, Craigslist, Facebook Marketplace)EmployerIn PersonMailOnline add or Pop-upSocial MediaText MessageTV, Radio, or Print AdvertisementWebsite or AppOtherDid you lose money or do you have a monetary dispute?*YesNoHow did you pay?CashCheckCredit CardDebit CardGift Card | Refillable Prepaid card (ex. iTunes, Google Play, MoneyPak)Financing (ex. Automobile Loan)Payment App or Service (ex. PayPal, Apple Pay, Venmo,Crypto Currency (ex. BitCoin)Money OrderSomething ElseHow much did you lose or is in dispute?Please provide the actual amount of money you lost or the actual amount in dispute. Does your issue relate to the COVID-19 Pandemic?*Examples include COVID-19 related pricing and refund issues, public health concerns, travel cancellations, unemployment and loan fraud, and COVID-19 related scams.YesNoPlease select the type of COVID-19 issue you are reportingPrice GougingPublic Health ConcernsRefunds or CreditsUnemployment FraudVaccine Specific ScamsOtherComplaint Narrative*Please present the facts in the order in which they occurred and be as concise as possible, providing dates and full names of those you dealt with during your transaction. Do not provide confidential information, such as Social Security numbers, bank account and credit card numbers, driver's license, health/medical information, and other sensitive information. About the Company or IndividualName of Person you talked toName of Company or Individual*If applicable, please provide any other names this business or entity operates underAddress Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhoneEmail WebsiteAll website entries must start with one of the following prefixes: http:// or https://. If the website is unknown or entry errors occur, please leave blank. About YouName First Last Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PhoneYour Email Demographic InformationThis information is collected for statistical purposes only and is optional. Please simply click submit to file your complaint if you prefer not to provide this information.Age RangeUnder 1818 - 2425 - 3940 - 6060 +I identify my ethnicity as:AsianBlack - African AmericanHispanic - LatinxNative AmericanPacific IslanderWhiteOtherI prefer not to answerLanguage Spoke at HomeEnglishSpanishChineseFrenchGermanVietnameseOtherAre you an active or retired military member?YesNoAcknowledgement*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.
