Fraud.org's Online Fraud Report Form

Instructions:

Use this form to report suspected telemarketing or internet fraud. Telemarketing can include offers made by mail or other means that ask you to respond by phone. The information you provide will be transmitted to the appropriate law enforcement agencies. To understand what happens with your complaint, read our Frequently Asked Questions. If the problem is not telemarketing or Internet fraud, contact your state attorney general’s office for advice. All fields marked by * are required to be filled in.


Your Information

*First Name:

*Last Name:

*Email Address:

*Street Address:

*Apartment number, unit, suite, etc.:

*City:

*State/Province:

*Zip Code/Postal Code:

Country:

Home Phone:

(Please include area code or country code.)

Work Phone:

(Please include area code or country code.)

Year of Birth:

(i.e., 1936—for statistical purposes only)


Complaint Information

*Name of seller or company:

Web site address:

Email Address:

Street Address:

Suite number, unit, etc.:

City:

State/Province:

Zip Code/Postal Code:

Country:

Phone Number:

(Please include area code or country code.)

First name of salesperson you dealt with:

(Provide additional names in description of complaint below.)

Last Name:

How did you first encounter this company/individual:


(If through an online auction, job listing, socialnetworking site, etc. please choose Web site.)

Date of first contact with seller/company:

/ / (MM/DD/YYYY)


Payment Information

If the seller/company asked for money, how much?

$ (In U.S. dollars)

If you paid the seller/company, how much?

$ (In U.S. dollars)

How did you pay?

If credit card charge or debit, name of bank:

DO NOT provide your credit card or bank account number. We DO NOT need that information.

How did you transmit the payment to the seller/company?

*Description of complaint (please press [ENTER] at the end of every line). Explain exactly what happened; what goods or services were offered, if any; what you have tried to do to resolve the problem; and any other details you think are important that were not captured in the form above. Please be as brief as possible. Thank you.


   

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