Complaint Information Sheet

COMPLAINT INFORMATION SHEET. This form from the Missouri Secretary of State’s Securities Division is used by individuals to report concerns or problems involving investments, financial representatives, or securities companies operating in Missouri. This form allows an investor to provide detailed information about a suspected case of fraud, misrepresentation, or other misconduct related to the offer or sale of securities. It collects personal and contact information from the complainant, as well as details about the company or representative involved, the nature of the investment, and the circumstances of the transaction. Investors are asked to describe what they were promised, how much they invested, the method of payment, and whether they received supporting documents such as contracts or prospectuses. The form also asks if the investor has sought legal help or contacted other agencies. Supporting documentation is encouraged to assist the Securities Division in its review. While the division cannot act as a private attorney, the form provides a formal channel for initiating an investigation into potential violations of securities laws. www.FormsWorkflow.com