Consumer Complaint Form

Consumer Complaint Intake Form

Consumer Information


Company Information

Company or Seller:
Company Address:
Company Phone:
Company Email:

Complaint Information

Please enter a clear description of the complaint (e.g. nature or type of complaint)
Description of Complaint*
Complaint Type:
Date problem first occurred:
Date(s) you complained to Company:
To whom you complained:
Order/File Number:
Product or service (e.g. closing fees)

Please enter the code below and press submit to submit complaint to Statewide Title Services, Inc.

Word Verification:

Thank You!

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