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Organization Title

COMPLAINT FORM
APPRAISAL MANAGEMENT COMPANIES (AMC)
COMPLAINT OF UNETHICAL OR UNLAWFUL CONDUCT

Read the Complaint Form instructions before completing this form.


INFORMATION ABOUT YOU (Complainant)
1. Last NameFirst NameMI
2. Business Phone3. Home Phone
4. Business Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable) - Public Record
5. Home Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
6. Relationship to Complaint (Client, Lender, Bank, Review Appraiser, etc.)
7. Reason for Appraisal (Refi, Tax, Divorce, etc., or other action which generated this complaint)


INFORMATION ABOUT THE APPRAISAL MANAGEMENT COMPANY (AMC)
8. Name of Appraisal Management Company
9. BREA Certificate of Registration Number
10. Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
11. Business Telephone Number
12. Date and County Transaction Occurred
13. Address of Property Involved
14. Have you contacted the AMC regarding your complaint?
Yes    No
15. Name of Initial Contact Person of the AMC
Please list the name(s) of all additional AMC contacts:
Date(s) of ContactPerson(s) ContactedResults


16. Have you filed this complaint with another agency, including the Law Enforcement?
Yes    No
Name of Agency and Person Contacted
Address and Phone Number of Agency
Results of That Complaint (if any)


17. Have you retained an attorney in this matter? (If applicable)
Yes    No
If YES, please include the following:
Name of AttorneyBusiness Phone
Address of Attorney (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
18. May we contact your attorney with reference to this matter?
Yes    No


19. Is this complaint related to any action filed or pending in any court?
Yes    No
If YES, please complete the following and give details in Number 23. (Attach additional sheets if necessary)
Name of Court
Address of Court (Street, City, State, Zip Code)
Type of ActionCase Number


20. Were there any witnesses who have knowledge of the events described in this complaint?
Yes    No
If YES, please complete the following and give details in Number 23 below.
Full Name of Witness #1
Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
Your Relationship to the WitnessDaytime Telephone Number
Full Name of Witness #2
Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
Your Relationship to the WitnessDaytime Telephone Number
Full Name of Witness #3
Address (Street, City, State, Zip Code; Include Apartment or Suite Number if applicable)
Your Relationship to the WitnessDaytime Telephone Number
22. In the form of a brief statement, please give the full details of your complaint. Be factual.
Try to answer the questions: Who, What, When, Why and How.
23. Continuation


You may be asked to provide documentation
supporting your complaint, in the form of:

  1. Appraisal
  2. Appraisal Order Form or Contract
  3. AMC Policies
  4. Other Miscellaneous Correspondence
        

State of California Department of Consumer Affairs