Consumer Complaint | Missouri Division of Finance

Missouri Division of Finance Complaint Form

Missouri Division of Finance
P.O.Box 716
Jefferson City, Missouri 65102-0716
Phone: 573-751-3242
Fax: 573-751-9192
Email: complaint@dof.mo.gov

Please Note:

We will review your complaint as soon as possible, however, please allow 30 days for a response.
We cannot act as a court of law or as a lawyer on your behalf
We cannot give you legal advice
We cannot become involved in complaints that are in litigation or have been litigated

* Required Fields

Personal Information

Salutation:

*First Name:

MI :

*Last Name:

*Street Address:

*City:

*State:

*ZIP:

*Primary Telephone Number:

Secondary Phone Number:

E-mail Address:

Additional Contact Information

If you want us to communicate with someone else, such as a family member, attorney or other person representing you regarding this complaint, please provide your representative’s information below. We may share any information regarding this matter with the representative provided.

Name of Represenative:

Relationship:

Street Address:

City:

State:

ZIP:

Phone: (e.g., (573) 555-1212)

Financial Institution or Company subject to the Complaint

*Name of Institution:

Street Address:

*City:

*State:

ZIP:

Phone: (e.g., (573) 555-1212)

*Type of Accounts

Deposit Accounts:

Loans:

Other:

Have you tried to resolve your complaint with the financial institution or company?

If Yes, When?

Describe?

Contact Name:

Title:

Have you filed a complaint or contacted another government agency?

If Yes, Agency Name?

Agency Contact

Complaint Information

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 dates(s) of any transaction(s).

Be as brief and complete as possible to make the explanation clear.

You may be requested to supply copies of documents related to your complaint such as contracts, monthly statements, receipts, and correspondence with the financial institution.

Details of my complaint:

Please be advised that the issues described in this complaint may be shared with the financial institution or company for their response. It may also be shared with other government agencies.

Desired Resolution

What action by the financial institution or company would resolve this matter to your satisfaction?

I certify that the information provided is true and correct to the best of my knowledge.

*Submitted By: