Please provide a written explanation of your complaint by describing a timeline of events and noting dates of
transactions, interactions, the names of individuals, and names of businesses involved. If you need more space, you
may provide it as an attachment. Enclose copies of documents that are relevant to your issue.
What do you believe would be a fair resolution to this matter?
I agree that the information provided within this complaint (and any attachments) is correct to the best of my knowledge. If I
am filing this complaint on behalf of another, I affirm that I have the complainant's permission to do so. I give the OCCC
permission to discuss or provide a copy of this information to the individual or company I am complaining about. If my
complaint concerns violation of state or federal law outside the OCCC's jurisdiction, the OCCC may forward it to the appropriate
agency.
Signature Date
Note: You may either mail this form or return it as an attachment via e-mail. A signature is not required for those forms returned via e-mail, however,
choosing to return the form via e-mail will also be considered an affirmation of the statements above.
Return to: Office of Consumer Credit Commissioner • 2601 N Lamar Blvd • Austin TX 78705 •E-mail: consumer.complaints@occc.texas.gov