No-Call Complaint

* First Name:

Middle Initial:

* Last Name:

Address:

City:

* State:
Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code:

* Email Address:

If you provide an email address, a copy of this request will be sent to you automatically by email.

* Number registered on no-call list:

Please list the phone number, registered on the No-Call List, to which you received an unsolicited call.

Type of Number registered on no-call list:
Residential
Business
Cellular
Other

Name of Company:

Name of Representative:

D/B/A Name:

Address:

City:

State:
- select - Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska Nevada New Hampshire New Jersey New Mexico New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code:

Country:

Email Address:

* Telemarketer Phone Number:

Date of Call:
 
MM/DD/YYYY

Time of Call:

XX:XX AM/PM

1. Was the telemarketer calling to solicit contributions on behalf of a charity?:
Yes
No

2. Was the telemarketer calling on behalf of a political candidate, organization or party?:
Yes
No

3. Was the telemarketer calling to conduct a poll?:
Yes
No

4. Did the telemarketer call you in response to your express request?:
Yes
No

5. Have you made any application, purchase or transaction with this company within the past 18 months?:
Yes
No

6. Was the telemarketer calling to sell you a product or services, to extend credit to you, or to set up a meeting to sell you a product or service?:
Yes
No

7. Did the telemarketer:

8. Did you tell the telemarketer that your phone number is registered on the No-Call list?:
Yes
No

9. Was the Caller ID blocked by the telemarketer?:
Yes
No
I do not have Caller ID

10. Was the telemarketing message a recording?:
Yes
No

11. Did the telemarketer use threatening, intimidating or profane language?:
Yes
No

12. If this company has called you in the past, did you at that time ask them not to call you again?:
Yes
No

13. Would you be willing to testify in court regarding this complaint?:
Yes
No

14. Is there any additional information you wish to provide?:

In filing this request, I understand and agree that the Attorney General and the Attorney General's Office staff are not my private attorneys, but instead represent the State of Kansas in enforcing laws designed to protect the public from deceptive and unconscionable business acts and practices. I understand that Kansas Law limits the period of time during which I may file any private legal action(s). I further understand and agree that the contents of this request may be forwarded to the business or person the request is directed against, may be forwarded to other appropriate agencies, and will become accessible to others under the Kansas Open Records Act. I hereby authorize any party to whom the Attorney General directs this complaint to release any and all information about this matter, including account information, to the Kansas Attorney General's Office. Finally, I declare and verify under penalty of perjury and the laws of Kansas that all of the foregoing is true and accurate to the best of my knowledge.

* Please certify your agreement to the above statement by typing your full name in the box below:

* Type the characters you see in the image below: