Confidential Complaint Form

If you have additional materials relevant to your complaint (contracts, billing statements, collection agency letters, etc.) please mail them to us separately.

Please note: Although it is most unlikely that you will experience any problems using this form, certain non-standard browsers will not respond properly. If you experience any difficulties, (or if you are not using a forms-capable browser) you may send an email to:Tammie L. Breton

Disclaimer: We cannot process your complaint unless you first have contacted the business and tried to resolve the issue on your own.
1. Who is the complaint against
Telephone   (e.g.,. 207-555-1111)
(If unknown, please enter unknown)
Yes No If you have checked "No," please keep in mind that we are a state regulatory agency that handles complaints relating to the State of Maine. Please consider contacting your own state's Attorney General's office. If you are trying to reach the new federal agency that is known by a name similar to ours (the "Consumer Financial Protection Bureau," or CFPB), then click here to file a complaint with the federal CFPB.

2. Name of the primary person you dealt with
(Please list any additional people in the complaint details area.)

3. Complaint
If this complaint relates to a debt, include the amount owed.
Yes No

4. Customer Authorization
Yes No

5. Information About You

Mr. Ms Mrs.
Telephone (Daytime)
  (e.g., 207-555-1111)
Telephone (Evening)   (e.g., 207-555-1111)
Fax Number   (e.g., 207-555-1111)
Today's Date