"Collection Agency Complaint Form" - Idaho

Collection Agency Complaint Form is a legal document that was released by the Idaho Department of Finance - a government authority operating within Idaho.

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BRAD LITTLE
Governor
MARY HUGHES
Acting Director
Dear Consumer:
Attached is the Complaint Form you requested.
Please complete this form and submit copies of
supporting documents to the Department at the address located at the bottom of this letter. If you have
not already attempted to resolve your dispute with the business or person you are complaining against,
you are encouraged to do so prior to submitting a complaint.
By submitting your complaint, you acknowledge and understand that the Idaho Department of Finance
does not represent individual consumers in the handling of complaints, and the Department’s consumer
response process may not result in a resolution that is satisfactory to you.
The Department investigates complaints that allege business practices that violate laws enforced by the
Department. The receipt of this information allows the Department to identify and devote resources to
serious cases involving the potential for widespread harm to Idahoans.
Information provided by
consumers, like you, is indispensable to the Department’s law enforcement efforts.
Unless you specifically request otherwise, your complaint will be provided to the business or person
complained against, with a request for a written response.
In addition to filing a complaint with the Department of Finance, you may also want to consider the
following options:
1. The Better Business Bureau may be able to assist you in mediating your dispute with a business.
2. You may want to consider filing a claim in small claims court if the amount in controversy is less than
$5,000.
3. If the amount in controversy is more than $5,000 you may wish to consult a private attorney. If you
do not have an attorney you may contact the Idaho State Bar Lawyer Referral Service at: Idaho State
Bar, P.O. Box 895, Boise, Idaho 83701, (208) 334-4500. The Idaho State Bar and Idaho Law
Foundation, Inc.’s website can be located at: http://isb.idaho.gov.
4. Depending upon household income and other factors, you may qualify for legal assistance from the
Idaho Volunteer Lawyers Association. More information about this program can be found online at:
http://isb.idaho.gov/ilf/ivlp/seeking_legal_assistance.html.
Your written complaint will become part of the Department’s file concerning the business or person
complained against, and will assist the Department in determining whether further action is warranted on
behalf of the state of Idaho.
Please be advised that once submitted, your complaint will become a public record that may be inspected
by the public if a request is made under Idaho’s public records law. Your time and attention in submitting
this information is appreciated.
Sincerely,
The Idaho Department of Finance
CONSUMER FINANCE BUREAU
Bureau Chief – Anthony Polidori
800 Park Blvd, Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8002 Fax: (208) 332-8099
http://finance.idaho.gov
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE 1905
BRAD LITTLE
Governor
MARY HUGHES
Acting Director
Dear Consumer:
Attached is the Complaint Form you requested.
Please complete this form and submit copies of
supporting documents to the Department at the address located at the bottom of this letter. If you have
not already attempted to resolve your dispute with the business or person you are complaining against,
you are encouraged to do so prior to submitting a complaint.
By submitting your complaint, you acknowledge and understand that the Idaho Department of Finance
does not represent individual consumers in the handling of complaints, and the Department’s consumer
response process may not result in a resolution that is satisfactory to you.
The Department investigates complaints that allege business practices that violate laws enforced by the
Department. The receipt of this information allows the Department to identify and devote resources to
serious cases involving the potential for widespread harm to Idahoans.
Information provided by
consumers, like you, is indispensable to the Department’s law enforcement efforts.
Unless you specifically request otherwise, your complaint will be provided to the business or person
complained against, with a request for a written response.
In addition to filing a complaint with the Department of Finance, you may also want to consider the
following options:
1. The Better Business Bureau may be able to assist you in mediating your dispute with a business.
2. You may want to consider filing a claim in small claims court if the amount in controversy is less than
$5,000.
3. If the amount in controversy is more than $5,000 you may wish to consult a private attorney. If you
do not have an attorney you may contact the Idaho State Bar Lawyer Referral Service at: Idaho State
Bar, P.O. Box 895, Boise, Idaho 83701, (208) 334-4500. The Idaho State Bar and Idaho Law
Foundation, Inc.’s website can be located at: http://isb.idaho.gov.
4. Depending upon household income and other factors, you may qualify for legal assistance from the
Idaho Volunteer Lawyers Association. More information about this program can be found online at:
http://isb.idaho.gov/ilf/ivlp/seeking_legal_assistance.html.
Your written complaint will become part of the Department’s file concerning the business or person
complained against, and will assist the Department in determining whether further action is warranted on
behalf of the state of Idaho.
Please be advised that once submitted, your complaint will become a public record that may be inspected
by the public if a request is made under Idaho’s public records law. Your time and attention in submitting
this information is appreciated.
Sincerely,
The Idaho Department of Finance
CONSUMER FINANCE BUREAU
Bureau Chief – Anthony Polidori
800 Park Blvd, Suite 200, Boise, ID 83712
Mail To: P.O. Box 83720, Boise ID 83720-0031
Phone: (208) 332-8002 Fax: (208) 332-8099
http://finance.idaho.gov
PROTECTING THE INTEGRITY OF IDAHO FINANCIAL MARKETS SINCE 1905
Idaho Department of Finance
Complaint Form
Idaho Department of Finance
800 Park Blvd., Suite 200
Boise, ID 83712
Y
I
OUR
NFO RMATION
Salutation: Mr.
Ms.
Mrs.
Other:
First Name:
Middle Initial:
Last Name:
Street Address:
City:
State:
Zip:
-
Home Phone:
Work Phone:
Email:
What is the best way to contact you? Phone
Mail
Email
What is the best time to contact you? Morning
Afternoon
Evening
A
C
I
DDITIO NAL
O NTACT
NFO RMATION
If you want the Idaho Department of Finance to communicate with someone else, such as a
family member, attorney, or other person representing you about your complaint, please provide
that person’s information below. If you list someone else and sign this form, you are authorizing
the Department to communicate with and provide relevant information about you and your
complaint to that person.
Name of Representative:
Relationship:
Street Address:
City:
State:
Zip:
-
Phone:
I
A
B
P
B
C
A
NFORMATIO N
BOUT THE
USINESS OR
ERSON
EING
OMPLAINED
G AINST
Name of Business or Person:
Street Address:
City:
State:
Zip:
-
Phone:
Type of account(s): Credit Card:
Checking
Mortgage
Other:
Mortgage
Have you tried to resolve your complaint with the business or person? Yes
No
If yes, when?
How? Phone
Mail
In Person
Other
Have you filed a complaint or contacted another government agency? Yes
No
If yes, agency name?
C
I
OMPLAINT
NFORMATION
Describe events in the order in which they occurred, including any names, phone numbers, and
a full description of the problem with the amount(s) and date(s) of any transaction(s). You
should also include any response that you have received from the business or person being
complained against. Be as concise and complete as possible to make the explanation clear.
Please be advised that the issues described in this complaint will be shared with the business or
person complained against, to allow them to respond.
Add more pages if necessary
D
R
ESIRED
ESOLUTIO N
What action by the business or person complained against would resolve this matter?
A
C
CKNOWLEDGEMENT AND
ERTIFICATION
Once completed and submitted, this complaint will be a public record and as such may be
inspected by the public if a request is made under Idaho’s public records law.
I certify that the information provided on this form is true and correct to the best of my
knowledge. I understand that the Department of Finance cannot act as my private attorney, but
rather acts on behalf of the public by enforcing laws governing financial service providers when
it is in the public interest to do so. I understand that the Department of Finance does not
represent private individuals seeking the return of their money or other remedies.
I am,
however, filing this complaint to notify the Department of Finance of the activities of this
company.
Signature: ______________________________________________Date: _________________
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