Translator Disclaimers

To file a complaint, please complete the form below. Required fields are marked with a red asterisk ( * ).

Complaint type:    
* Account Type:
* First Name:
* Last Name:
  Business Name:
* Street Address:
  Address 2:
* City:
State:
* Zip:
  County:
* Primary Phone Number:
  Secondary Phone Number:
* E-mail:
If different from the address above
  Mailing Address:
  Address 2:
  City:
  State:
  Zip:
     
Utilty Company Name:
  Account Number:
(or phone# for telephone complaints) 
* Problem Description:(Maximum of 1000 characters)