facebook
twitter
linkedin

(800) 981-4429

Email Us

File A Complaint

Fill out the online complaint form below, or

Download Form (PDF)

Instructions:

Upon receipt of a properly completed Complaint Form, the Arkansas Securities Department (ASD) will review the complaint and, generally request a response from the company or individual that is the subject of the complaint. Based on this information, ASD will decide whether or not to begin a formal investigation. If a formal investigation begins, it will ordinarily remain confidential, as will any related documentation. You are invited to attach photocopies (no originals please) of supporting documents to the Complaint Form.
Please Check One:(Required)

Please provide the following information about yourself:

Name(Required)
Address(Required)
Best time to call(Required)
:

Please provide the following information about the company your compaint is against:

Address(Required)

Person you dealt with at the company:

Name(Required)

Please provide information regarding legal representation/action:

PLEASE READ BEFORE SIGNING:

By signing this Complaint Form I acknowledge that (1) the information I have provided is true to the best of my knowledge and belief, (2) I have read and understand the Notice in the paragraph below, and (3) I authorize the ASD to provide information from this Complaint Form to the company that is the subject of the complaint, or to use the information I have provided in any manner deemed necessary or proper by the ASD.

NOTICE:

The ASD does not provide personal legal advice, nor will it represent you in court proceedings. Also ASD cannot decide disputes, arbitrate claims or order firms to pay judgments in personal disputes. In order to recover lost funds or obtain comparable relief, you may have to initiate private legal action; prompt action on your part is critical because state and federal laws known as “Statutes of Limitations” impose strict time limits on filing law suits. Thus, you may wish to contact an attorney immediately. For names of attorneys in your area, call the Arkansas Bar Association or your local bar association.
Signature:(Required)
MM slash DD slash YYYY
Max. file size: 50 MB.
Powered by Lapero