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Complaint Form - CSLB-Home -CSLB

_____ _____ | 13I-15 (Rev. 03/04/11 page 1 of 2) CONTRACTORS STATE LICENSE BOARD STATE OF CALIFORNIAN orthern California: Sacramento Intake & Mediation Center Box 269116, Sacramento, California 95826-91161-800-321 -CSLB (2752)Southern California: Norwalk Intake & Mediation Center12501 East Imperial highway , Suite 620, Norwalk, California 906501-800-321 -CSLB (2752) FormNOTICE: INCOMPLETE AND UNSIGNED FORMS WILL BE RETURNED TO NOT SEND ORIGINALS DOCUMENTS RECEIVED WILL NOT BE COPIED AND/OR attach COPIES of all pages of contracts (front a)

12501 East Imperial Highway, Suite 620, Norwalk, California 90650 1-800-321-CSLB (2752) www.cslb.ca.gov . CheckTheLicenseFirst.com ... I will assist in the investigation or in the prosecution of the contractor or other parties, and will, if necessary, attend hearings and testify to facts. 28. SIGN HERE DATE: mailto:privacy@oispp.ca.gov:

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