DMV Consumer Complaint Center
Customer Complaint Form

* All fields with an asterisk are required

*Name: (First & Last Name)
*Address:
*City:
*State:
*Zip Code:
*Phone:
Complainant E-mail address (if there is one):
   
*Make:
*Model:
*VIN Number of Vehicle:
*Plate number:  
* Year of Vehicle:  
* Odometer reading at time of sale or repair:  
* Current Odometer reading:  
   
*Dealer Name:  
Dealer Phone:  
*Dealer Address:  
  *City:  
  *State:     
  *Zip Code:  
  *Dealer Contact/Salesperson:   (First & Last Name)
*General Description of Problem: (1000 characters max)
 

 

 


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