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Consumer Information - Consumer Complaint Form

Staff from Service Nova Scotia and Municipal Relations regularly mediate disputes between consumers and businesses. Mediation will only take place 1) if the issue in dispute falls under one of Nova Scotia's consumer protection laws, and 2) if the consumer has already tried to resolve the dispute with the business.

Please note that assistance is generally only provided for complaints dealing with the following areas:

- Cemetery and Funeral Services
- Consumer Loans and Mortgages
- Consumer Purchases
- Credit Reporting
- Debt Collection
- Direct Sellers
- Residential Tenancies has a separate dispute resolution process

If you're not sure whether we can help with your complaint, call 424-5200 or toll-free in Nova Scotia 1-800-670-4357. You will be contacted by telephone within 10 days of submitting this form.

To download the consumer complaint form for printing, please click on the PDF link below. * Download Consumer Complaints Form


* Please note: These forms are in Portable Document Format
(PDF), which uses the Adobe® Acrobat® Reader. If you do not
have the Reader, you can download the program free of charge.

CONSUMER COMPLAINT FORM
Part 1: Consumer Information
Name:
Address:
Home Phone:
Work Phone:
Fax:
E-mail Address:
Part 2: Complaint Against
Business Name:
Address:
Phone Number:
Contact Person:
Web Site:
Part 3: Complaint
Description of goods or services:
Value of Goods or Services:
Date of Supply of Goods or Services:
How was the purchase made?
How did you pay for your product or service?
Please describe what you have done to resolve your complaint. Complaint forms will not be accepted unless you have taken reasosnable steps to resolve this issue yourself.
What do you want the business to do to resolve your complaint?
Choose a location nearest you. This will be the site that will initially deal with your complaint.
Please provide copies of any receipts, contracts or other documents that are related to your complaint. Do not attach originals. If you are submitting this form on-line, please list and describe any supporting documentation you have:

Permission to Share Information

By signing below or by submitting this form on-line, you declare the information you provide to be true and correct. You are also consenting to the sharing of the information on this form with the business in question, any government department or law enforcement agency, and any self-regulatory body or association. Any personal information you provide will only be used for the purposes of complaint mediation or investigation.



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