CITY OF BUFFALO COMPLAINT AFFIDAVIT
Office of Licenses City Hall Room 301
65 Niagara Square Buffalo, NY 14202
You are advised to first attempt to resolve your complaint and keep a log of all telephone calls and copies of any pertinent
documents. If this business/person does not respond, you are advised to file your complaint with us.
The Office of Licenses will not act as a private attorney, but instead represent the public in enforcing laws designed to
protect the public from misleading or unlawful business practices. If you have questions concerning your legal rights or
responsibilities, you may contact a private attorney.
In addition to filing a complaint with the Office of Licenses, you may file a complaint with one of these agencies.
Buffalo Small Claims Court 716.845.2663 State Attorney General 716-853-8400 Better Business Bureau 716-881-5222
Provide the following information.
Clearly print or type your answers. It is important that the information you provide is thorough and clear.
Your name _________________________________________________________________________
Your address _________________________________________________________________________
Contact information: phone _____________________ /email ________________________________________
Business Name/Owner complaint is against___________________________________________________________
Business Address _______________________________________________________________________
Address site for complaint _______________________________________________________________________
1. If this is concerning a contractor, type of work performed _______________________________________
2. Cost of estimate for work ____________________ amount paid to date ________________________
3. Is this complaint against someone licensed in the City of Buffalo? □ yes □ no
4. What type of License do they hold? ________________________________________________________
5. Was any work contracted through a loan obtained with BURA or an affiliated agency? □ yes □ no
6. If complaint is against a contractor, does the contractor have a lien against your home? □ yes □ no
7. Has a decision already been reached in Small Claims Court or another meditative agency? □ yes □ no
8. Did you attempt to resolve this complaint with the business/person? □ yes □ no
If No, please explain why not. ___________________________________________________________
Describe your complaint on the reverse side of this form.
Mail this form and related documents to the above address
Include supporting documentation.
□ Copy of contract with signatures, if applicable
□ Photos of work performed (required)
□ Proof of payment (receipts, canceled checks)
□ Copy of warranty, if applicable
□ Copy of correspondence, if any
□ Other related documents
Print name ____________________________