DISTRICT ATTORNEY'S OFFICE
COUNTY OF PLACER
CONSUMER & ENVIRONMENTAL CRIMES UNIT
The following is my consumer complaint against the company/person I have named below. I understand that the District Attorney's Consumer & Environmental Crimes Division is unable to represent private citizens seeking return of their money or their personal remedies. I am, however, filing this complaint to notify your office of the activities of this company/person.
(PLEASE USE BLACK INK OR TYPE IF POSSIBLE)
Business/ Individual complained about:__________________________________________
Address:____________________________________________________________________
(Street Address) (City) (CA) (ZIP)
Is this business located in Placer County?______. If not, what County?________________
Telephone:________________________ Salesperson:______________________________
Date of incident:_______________ Product involved:______________________________
Was product advertised?______ If so, where?_____________________ When?________
Was money exchanged?______ If so, how much?________________________________
Your name:_________________________________________________________________
Telephone #s: Home:________________ Office:___________________________________
Address:____________________________________________________________________
(Street Address) (City) State) (Zip)
Name & Addresses of witnesses:________________________________________________
___________________________________________________________________________
May we send this Complaint to the business involved? Yes_______ No______
Describe events as they happened listing dates and names:__________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Was a contract signed?________If so, please attach a COPY of that contract. Please attach copies of any correspondence, documents, contracts, receipts, etc. that pertain to this complaint. (RETAIN ANY ORIGINALS FOR YOUR FILES).
The relief sought is:________________________________________________________________
Signed:_________________________________________________Date:____________________
Signed:_________________________________________________Date:____________________
Other agencies you have contacted for assistance (give names, addresses, & person contacted, if possible):________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________
PLEASE MAIL THIS FORM TO: Placer County District Attorney
Consumer/Environmental Crimes Unit
11562 B Avenue
Auburn, CA 95603