Complaint Input Form

COMPLAIN TO THE FEDERAL TRADE COMMISSION

Use this form to send a complaint to the Federal Trade Commission (FTC) Bureau of Consumer Protection about a campground, condominium, or timeshare company or organization. The information you provide is up to you. However, if you do not provide your name or other information, it may be impossible for them to refer, respond to, or investigate your complaint or request.

Your information will be sent directly and ONLY to the Federal Trade Commision (FTC).
NAM will NOT retain any of the information you submit on this form.

While the FTC does not resolve individual consumer problems, your complaint helps them investigate fraud, and can lead to law enforcement action. The FTC enters fraud-related complaints into Consumer Sentinel®, a secure, online database available to hundreds of civil and criminal law enforcement agencies worldwide.

Subject of Your Complaint:	(Includes Campgrounds and Timeshares
Name of Company You Are Complaining About:
Check If Company Name Is Unknown:
Street Address:
City:
State or Canadian Province:	"Click" Arrow for Choices
Country:	"Click" Arrow for More Choices
Zip Code or Postal Code:
Company Web Site:
Company E-Mail Address:
Phone Number:	Area Code ( ) Phone Number Ext. (Extension) (xxx) xxx-xxxx
How Did the Company Initially Contact You?	"Click" Arrow for Choices
How Much Did the Company Ask You to Pay?	(Numbers Only)
How Much Did You Actually Pay the Company?	(Numbers Only)
How Did You Pay the Company?	"Click" Arrow for Choices
Did You File a Dispute with the Credit Bureau?	"Click" Arrow for Choices
Did You File a Dispute with the Credit Bureau More Than 45 Days Ago?	"Click" Arrow for Choices
First Name of REPRESENTATIVE OR SALESPERSON
Last Name:
Date Company Contacted You:	(MM/DD/YYYY)
Explain Your Problem: (Llimit your complaint to 2000 characters.):	Concerning a campground membership or timeshare scheme:

• Did they say you had to pay 'dues' the rest of your your life or get someone else to do it?

• Did they say you had to get a new 'ID' then high pressure you into an 'upgrade'?

• Do they demand money from you even after you told them, in writing,
that you do not want to be a member?

• HOW WERE YOU MISLEAD, HIGH PRESSURED OR DECEIVED?

OMB #3084-0047

COMPLAIN TO THE FEDERAL TRADE COMMISSION

Your information will be sent directly and ONLY to the Federal Trade Commision (FTC).
NAM will NOT retain any of the information you submit on this form.

How Can the FTC Reach You?

Tell the FTC About Your Complaint...

First Name:
Last Name:
Age Range:	"Click" Arrow for Choices
Street Address:
City:
State or Canadian Province:	"Click" Arrow for Choices
Country:	"Click" Arrow for More Choices
Zip Code or Postal Code:
E-Mail Address:
Home Phone:	Area Code ( ) Phone Number (xxx-xxxx)
Work Phone:	Area Code ( ) Phone Number Ext. (Extension) (Numbers Only)

OMB #3084-0047

COMPLAIN TO THE FEDERAL TRADE COMMISSION

Your information will be sent directly and ONLY to the Federal Trade Commision (FTC). NAM will NOT retain any of the information you submit on this form.

How Can the FTC Reach You?

Tell the FTC About Your Complaint...

Your information will be sent directly and ONLY to the Federal Trade Commision (FTC).
NAM will NOT retain any of the information you submit on this form.