Transcription of Your Information - Pennsylvania Office of Attorney General
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Your Information Fields marked with (*) are required. Bureau of Consumer Protection15th Floor, Strawberry SquareHarrisburg, PA 171201-800-441-2555 PA check if you or an immediate family member is a member of the military or a check if you are age 60 or *STREET ADDRESS*CITY* STATE*5-DIGIT ZIP CODE* COUNTY*BEST PHONE NUMBER* ALTERNATIVE PHONE NUMBEREMAIL AGEC omplaint Information Fields marked with (*) are required. BUSINESS NAME*PERSON TO WHOM YOU SPOKEBUSINESS ADDRESSCITY* STATE5-DIGIT ZIP CODE BUSINESS PHONE NUMBER By providing your email address, you agree to receive email communications from the Pennsylvania Office of Attorney OR SERVICE PURCHASEDDATE PURCHASED PURCHASED PRICEFORM OF PAYMENT: CREDIT CARD ATM/DEBIT CARD PREPAID CARD OTHERWHERE AND HOW DID YOU SIGN THE C
Attached to this complaint form is an informational sheet which will help you in completion of the complaint form and also will explain in greater detail the mediation process. By signing below, I authorize the Bureau of ... complaint form from our website at www.attorneygeneral.gov or you can call our toll-free number, 1.800.441.2555, ...
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