Consumer Assistance Program: Online Complaint Form

Please complete the form below with your information and the information for the business you are filing the complaint against. You may mail any additional documentation to the following address, or email to consumer@uvm.edu.

Mailing Address:

146 University Place, Burlington, VT 05405
(802) 656-3183

	*field required (if unknown, enter "NA")
Information about you:
Your Full Name (First and Last):*
Your Address:*
Your City:*
Your State:*
Your ZIP:*
Your Daytime Phone:
Your E-mail Address:
Is your complaint related to Tropical Storm Irene?*	Yes No
Are you a senior citizen?	Yes No
Information about the business you are filing your complaint against:
Business Name:*
Business Street Address:*
Business City:*
Business State:*
Business ZIP:*
Business Phone:
Business E-mail:
How did you find CAP?:
Events as they happened:* Please provide as much detail as possible.
Amount of loss:*
Relief you desire:*

Last modified May 02 2013 01:56 PM