Complaint to Great American Title Company

For Record:

Your Information:

Name:

Address:
City:	State:	Zip Code:
Home Phone:	Cell Phone:	Work Phone:

Person Complaint is against:

Person Involved in incident:
Company Name:
Address:
City:	State	Zip Code:

Description of Complaint:

Place of Transaction:

Date of Transaction:

Guaranty File Number:

Address or Legal Description of Property involved in incident:

Please explain the circumstances surrounding your complaint below:

Description of Complaint

(Continue)

Resolution:

What action by the company or person (s) would resolve this matter to your satisfaction?

I verify, under penalty of law, that everything contained in the foregoing complaint is true and correct to the best of my knowledge and belief.

_________________________________________________ ___________________________

Signature of Complainant

Date