Submitted by lushenejj on Fri, 2017-09-08 12:36 Fill out this form to file a complaint. We will confirm receipt of your complaint. We will also notify you when the complaint is resolved. Public Records Disclosure Release Information? * Do not release my identifying information in response to a request for public records It’s OK to release my identifying information in response to a request for public records Your complaint is a public record under the Washington State Public Records Act (RCW 42.56). Your complaint may be released if someone requests it. If you provide identifying information in your complaint, your complaint is not anonymous. We may release your identifying information (including your name and contact information). You can choose to have your identifying information removed. Please note that this does not stop the release of your information as part of a court case or subpoena. Your Information Full name(s) * Mailing Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Residence address Different than mailing address Address for Residence City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Telephone * Email address * Whom Are You Filing A Complaint Against? Name(s) * Address City State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Telephone Email Address Who You Contacted Complaint/Problem Type of Transaction Date Transaction Occurred Does your complaint involve a student loan? Yes No Does your complaint involve a residential mortgage? Yes No Did you receive or pay for a loan modification? Yes No Provide a description of the problem (remember to include: who, what, when, why and how the event transpired.) * Will you give us copies of documents and correspondence relevant to your complaint? Yes No Additional Questions How should we send you updates about your complaint? * Email US Mail Are you on active duty in the armed forces, or a dependent of someone who is? * Yes No Are you submitting this complaint for someone else? Yes No If you are submitting this complaint for someone else, do you have that person’s permission to communicate with us about their complaint? We’ll need that person’s written, signed permission to communicate with you about the complaint. Yes No If you are not a party to the transaction described in the complaint, what is your involvement? Do you have an attorney? Yes No Attorney's name Name of law firm Attorney Address Attorney City Attorney State - None -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Attorney Zip Attorney Telephone Attorney Email Would you like us to send correspondence about your complaint to your attorney? If you choose yes, we will communicate with you through your attorney, rather than with you directly. Yes No How should we contact your attorney? Email US Mail Declaration By filling in my name and date below, I declare, under penalty of perjury under the laws of the State of Washington that the information contained in this complaint is true and accurate and the information may be used to further investigate the complaint. Full Name * Date * CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
