Protect the Good Life

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Your Last Name Required

Address (Line 1) Required

Address (Line 2)

Military (If applicable)

Active Duty

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Preferred Method of Correspondence Required

Regular Mail

Have you contacted the business/person about your complaint? Required

Yes

Have you contacted an Attorney about your complaint? Required

Yes

Complaint Reported Against

Complaint Information

Describe the facts which have led to the complaint and be sure to include if possible, the exact dates of important events Required

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Please attach copies of any checks, receipts and/or supporting documents. Please send clear, legible copies.

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Disclaimer

The information given above is true to the best of my knowledge and belief. I authorize the Nebraska Attorney General's Office to send this complaint form to the company or to the interested parties and to use the information given in any manner which is determined necessary. I understand that the Attorney General's Office is not my private attorney but represents the public in enforcing laws designed to protect consumers from misleading or unlawful business practices.

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Nebraska Attorney General

Consumer Protection Division