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Confidentiality Note This electronic transmission, when filled out, contains information for the Cape May County Department of Consumer Affairs/Div. of Weights and Measures, which is confidential. The information is intended only for their use. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited and that the documents should be returned to the sender immediately. In this regard, if you have received this information in error, please notify the sender or the department by telephone so that they can arrange for the prompt delivery of the original documents at no cost to you. Thank you. Consumer Complaint Form Instructions Questions: Email us at: [EMAIL REDACTED] or call the number below. To fill out the form, please bring it up on your computer screen. Place your cursor in the date field. Type in the information. Using the computer tab key(s), tab to each field and fill in the appropriate information. In the Yes or No blocks, a click of the left mouse button in the box will insert or remove a check mark. Continue until all applicable fields have been filled in. After you complete the form, print 2 copies of the form. Keep one for your records and mail or fax one back to us or bring it to the address below. If you mail or fax it to us, please sign on the appropriate line. Thank you. Location and Mailing Address: Cape May County Department of Consumer Affairs/Weights & Measures 4 Moore Road DN – 310/302 Cape May Court House, NJ 08210 Telephone: [PHONE REDACTED] or [PHONE REDACTED] Fax: [PHONE REDACTED] ---PAGE BREAK--- Confidentiality Note This electronic transmission, when filled out, contains information for the Cape May County Department of Consumer Affairs/Div. of Weights and Measures, which is confidential. The information is intended only for their use. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited and that the documents should be returned to the sender immediately. In this regard, if you have received this information in error, please notify the sender or the department by telephone so that they can arrange for the prompt delivery of the original documents at no cost to you. Thank you. CAPE MAY COUNTY DEPARTMENT of CONSUMER AFFAIRS Office of Weights and Measures Melanie Collette 4 Moore Road – DN 310/302 Commissioner Cape May Court House, NJ 08210 (609) 886-2903 Fax: (609) 886-2906 John G. Rechner Director CONSUMER COMPLAINT FORM [PLEASE PRINT] Date: COMPLAINANT Transaction date: SUBJECT (Business) Owner/Salesperson: Have you discussed your complaint with the subject? (Click in either box) Yes No If yes, when? The response(s)? NOTE: If you have not contacted the subject concerning your complaint, the investigator assigned to your case may require you to do so before a formal investigation of the matter is opened. Direct contact with the owner/manager will often result in satisfaction. Written contact may be preferable. Retain copies of any letters. Have you referred your complaint to any other agency(ies)? Yes No If yes, which agency(ies)? Any responses(s)/result(s)? Have you retained an attorney with regard to this complaint? Yes No If yes, provide attorney name and address: (PAGE 1) ---PAGE BREAK--- Confidentiality Note This electronic transmission, when filled out, contains information for the Cape May County Department of Consumer Affairs/Div. of Weights and Measures, which is confidential. The information is intended only for their use. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or the taking of any action in reliance on the contents of this information is strictly prohibited and that the documents should be returned to the sender immediately. In this regard, if you have received this information in error, please notify the sender or the department by telephone so that they can arrange for the prompt delivery of the original documents at no cost to you. Thank you. Have you (or your attorney) filed any legal proceedings against the subject regarding this complaint? Yes No If yes, explain: State your complaint, using extra sheet(s) of paper if necessary and signing same. Provide copies of any and all documents which may pertain to your complaint. Copy (ies) of this completed complaint form may be provided to the subject and/or other appropriate persons/agencies during the investigation and/or litigation of your complaint. Be advised that should investigation of this matter disclose any deliberate falsehoods on your part, this office may immediately cease all efforts in your behalf. What settlement of your complaint would you consider to be READ: By signing below I am signifying that all information I have provided is true, correct and complete to the best of my knowledge. Date: Signed: Name (Printed):