Consumer Complaint

Consumer Complaint Form
Office of the District Attorney
Consumer Protection Division
3501 Civic Center Drive, Room 145
San Rafael, CA 94903 (415) 473-6495
Your Personal Information
Consumer First Name*
Consumer Middle Name
Consumer Last name*
Company
Address*
City*
State*
ZIP Code*
Format: 99999[-9999]
Phone*
Format: (999) 999-9999
Check if applicable:

Email address is unknown
Email*
Format: example@example.com
Check if applicable:

I am over the age of 62.

Consumer Complaint Form