Form BK-0181 "Consumer Complaint" - Tennessee

What Is Form BK-0181?

This is a legal form that was released by the Tennessee Department of Financial Institutions - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 13, 2016;
  • The latest edition provided by the Tennessee Department of Financial Institutions;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form BK-0181 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Financial Institutions.

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Download Form BK-0181 "Consumer Complaint" - Tennessee

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Generated on 1/13/2016
Tennessee Department of Financial Institutions
Consumer Resources Section
Tennessee Tower, 26th Floor
312 Rosa L. Parks Avenue, Nashville, TN 37243-1102
Phone: 800-778-4215 Fax: 615-253-7794
Consumer Complaint
The Tennessee Department of Financial Institutions requires that complaints be written. The Department provides this form with
the understanding that you authorize this office to conduct an investigation to determine if a violation of Tennessee law has
occurred.
PLEASE NOTE HOWEVER THE DEPARTMENT:
1. Cannot act as a court of law or as a lawyer on complainant's behalf
2. Nor can we provide legal advice
3. Additionally, we cannot become actively involved in complaints that are in litigation or have been resolved by the court system.
Consumer Information:
First Name: *
Middle Name:
Last Name: *
Address 1: *
Address 2:
City: *
State: *
Zipcode: *
County: *
Phone (H):
Phone (W):
Phone (C):
Email:
Would you like to receive all correspondence from our office via email? *
Is this complaint related to your mortgage? *
If complaint involves a mortgage loan, please advise if it is: Select one
Investment Property or Owner Occupied
Mortgage Loan Number:
Are you behind on your mortgage or are you concerned that you will be soon?
Have you been assigned a workout negotiator or specific contact person from your mortgage company regarding your foreclosure issue? *
Do you have a foreclosure sale date?
When is the foreclosure sale date? *
Are you facing eviction?
When is the eviction date? *
Have you made a loss mitigation request to your mortgage company?
What date did you send in the loss mitigation request? *
Have you received a response from your loss mitigation request?
Respondent Information:
Company/Individual: *
Address 1:
Address 2:
City: *
State: *
Zipcode: *
County: *
Phone:
BK-0181 - (Rev. 11/13)
Page 1 of 2
Generated on 1/13/2016
Tennessee Department of Financial Institutions
Consumer Resources Section
Tennessee Tower, 26th Floor
312 Rosa L. Parks Avenue, Nashville, TN 37243-1102
Phone: 800-778-4215 Fax: 615-253-7794
Consumer Complaint
The Tennessee Department of Financial Institutions requires that complaints be written. The Department provides this form with
the understanding that you authorize this office to conduct an investigation to determine if a violation of Tennessee law has
occurred.
PLEASE NOTE HOWEVER THE DEPARTMENT:
1. Cannot act as a court of law or as a lawyer on complainant's behalf
2. Nor can we provide legal advice
3. Additionally, we cannot become actively involved in complaints that are in litigation or have been resolved by the court system.
Consumer Information:
First Name: *
Middle Name:
Last Name: *
Address 1: *
Address 2:
City: *
State: *
Zipcode: *
County: *
Phone (H):
Phone (W):
Phone (C):
Email:
Would you like to receive all correspondence from our office via email? *
Is this complaint related to your mortgage? *
If complaint involves a mortgage loan, please advise if it is: Select one
Investment Property or Owner Occupied
Mortgage Loan Number:
Are you behind on your mortgage or are you concerned that you will be soon?
Have you been assigned a workout negotiator or specific contact person from your mortgage company regarding your foreclosure issue? *
Do you have a foreclosure sale date?
When is the foreclosure sale date? *
Are you facing eviction?
When is the eviction date? *
Have you made a loss mitigation request to your mortgage company?
What date did you send in the loss mitigation request? *
Have you received a response from your loss mitigation request?
Respondent Information:
Company/Individual: *
Address 1:
Address 2:
City: *
State: *
Zipcode: *
County: *
Phone:
BK-0181 - (Rev. 11/13)
Page 1 of 2
Amount Involved:
Date of Transaction:
Type of Transaction or Service: Select one
Bank, Credit Union, Mortgage, Pay Day, Title Pledge, Money Transmitters, Consumer Loan or Unknown
Have you contacted the financial institution?
Please provide the name of the person you spoke to at the financial institution, as well as the date(s) of contact:
Retained an attorney? *
Attorney Phone:
If yes, please provide the name and address of the attorney:
has a lawsuit been filed? *
If yes, please provide the case or docket number and name of court: *
Please provide a detailed explanation of your complaint issues: Attach additional sheets if needed to explain the situation
By submitting this information, I hereby attest to the accuracy or truthfulness of the content.
I authorize the Department of Financial Institutions to send this complaint form to the financial institution
or use the information given in any other manner deemed necessary or proper.
If applicable, add attachments to this complaint.
Signature
Date
BK-0181 - (Rev. 11/13)
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