CUSTOMER COMPLAINT FORM

OMB Control No. 1557-0232
Expiration Date: 7/31/2024

Please fill in this form completely. Once we receive your form, you will receive a confirmation e-mail. You will receive a separate e-mail containing your assigned case number within 48 hours. Please keep your case number for future contact with our office.You will have the option to PRINT the form after submission.

The OCC recommends that you attempt to resolve your complaint with your financial institution first. Please contact your financial institution to allow them the opportunity to resolve your issue(s).

Helpful Hints:
  • Check to make sure that your financial institution is a national bank or federal savings association (thrift). Search Financial Institutions (a new browser window will open). If you don't know the name of your financial institution, check your bank or credit card statement. The institution's name will be indicated on the statement.
  • If your complaint involves more than one financial institution, you will need to submit a separate complaint form for each institution involved. You will receive separate case numbers for each institution. Do NOT send additional information unless requested.
  • You should NOT fax, or mail a complaint in addition to this online submission. Only ONE form should be submitted unless your complaint involves more than one financial institution.
  • The online form is subject to a 30-minute user time limitations for security purposes. If your session exceeds the limitations, any information you have entered will be lost. To avoid this, gather all necessary information prior to entering the form.
Please Note:
  • We cannot act as a court of law or as a lawyer on your behalf
  • We cannot give you legal advice
  • We cannot become involved in complaints that are in litigation or have been litigated

Have you tried to resolve your complaint with your financial institution? *

page: 1/6