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Your City, State, Zip Code
(Your e-mail if sending via e-mail)
Name of Contact Person (if available)
Title (if available)
Consumer Complaint Division (if you have no specific contact)
City, State, Zip Code
Dear (Contact Person or Organization Name):
Re: (account number, if applicable)
On (date), I (bought, leased, rented, or had repaired) a (name of the product, with serial
or model number or service performed) at (location, date and other important details of
Unfortunately, your product (or service) has not performed well (or the service was
inadequate) because (state the problem). I am disappointed because (explain the problem:
for example, the
product does not work properly, the servicewas not performed correctly, I was billed the
wrong amount, something was not disclosed clearly or was misrepresented, etc.).
To resolve the problem, I would appreciate your (state the specific action you want—money
back, charge card credit, repair, exchange,etc.) Enclosed are copies (do not send
originals) of my records (include receipts, guarantees, warranties, canceled checks,
contracts, model and serial numbers, and any other documents).
I look forward to your reply and a resolution to my problem and will wait until (set a time limit)
before seeking help from a consumer protection agency or Better Business Bureau. Please
contact me at the above address or by phone at (home and/or office numbers with area
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