Free Utility Complaint Form

Please complete all sections to ensure your complaint is addressed efficiently and effectively.
Personal Information
Name
Address
Phone Number
Account Number (if applicable)
Complaint Details
Date of Incident
Service Type
Check one:
Electricity
Water
Gas
Internet/Telecommunications
Location of Issue (if different from your address)
Nature of Complaint
Check all that apply:
Service Interruption
Billing Discrepancy
Poor Customer Service
Equipment Malfunction
Delayed Installation or Repair
Description of Incident
Provide a detailed account of the issue, including relevant dates, times, and service details. Attach additional pages if necessary.
Action Taken
Have you reported this issue to anyone else?
If yes, please specify:
Desired Resolution
Describe how you would like this to be resolved.
Supporting Document
Upload a file to support the complaint.
By signing below, I affirm that the information provided is accurate to the best of my knowledge.
Name:
Signed:
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