New York > Secretary Of State > Blue Sky > Investor Protection And Securities
Online Brokerage Service Complaint Form - New York
| Online Brokerage Service Complaint Form Form. This is a New York form and can be used in Investor Protection And Securities Blue Sky Secretary Of State . |
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ATTORNEY GENERAL ELIOT SPITZER NEW YORK STATE OFFICE OF THE ATTORNEY GENERAL INTERNET BUREAU/ INVESTOR PROTECTION AND SECURITIES BUREAU 120 BROADWAY, 26th FLOOR NEW YORK, NY 10271-0332 TEL: (212) 416-8433 FAX: (212) 416-8369 http://www.oag.state.ny.us ONLINE BROKERAGE SERVICE COMPLAINT FORM 1. PLEASE BE SURE TO COMPLAIN TO THE ONLINE BROKERAGE SERVICE BEFORE FILING. 2. PLEASE TYPE OR PRINT CLEARLY IN DARK INK. 3. YOU MUST COMPLETE THE ENTIRE FORM AND SIGN THE VERIFYING STATEMENT ON THE REVERSE. INCOMPLETE OR UNCLEAR FORMS WILL BE RETURNED TO YOU. 4. MAKE SURE YOU ENCLOSE COPIES OF IMPORTANT PAPERS CONCERNING YOUR TRANSACTION, SUCH AS: YOUR CONTRACT, DOCUMENTATION OF YOUR PAYMENT, TRANSACTIONS STATEMENTS, TRANSACTION CONFIRMATIONS AND ANY CORRESPONDENCE YOU HAVE HAD WITH THE COMPANY (INCLUDING E-MAIL) CONSUMER Name Street Address City/Town County Home Tel. Bus. Tel. ( ) @ State Zip ( ) E-mail address COMPLAINT Name of Online Brokerage Service ("OBS") Internet address http://www. Street Address ___________________________________________________________________________________________________________________ City/Town County State Zip __________________________________________________________________________________________________________________ Telephone E-mail address (_____)_____________________________________________________________@____________________________________________ Type of account (e.g., stock, mutual fund, IRA, options) Total Amount of Investment $ Date of Transaction(s) Time Stock Name or Symbol # of Shares Nature of Transaction(s) [Additional details may be provided on reverse] Was product or service advertised? ( ) Yes ( ) No Date of advertisement:_________________ If yes, describe the nature of the advertisement (e.g., newspaper/magazine advertisement, television commercial, web posting, e-mail solicitation, standard mailing) and attach copies of the advertisement, screen printout and/or mailing. Date(s) you complained to the OBS: ________________ Person Contacted Job Title ( ) By mail ( )By e-mail ( ) By telephone ( ) In person ( ) Other Nature of Response (Attach copies of any correspondence) Date of Response _________________________________________________________________________________________________________________ Has matter been submitted to another agency or attorney? ( ) Yes ( ) No If yes, give name and address: __________________________________________________________________________________________________________________ Is court action pending? ( ) Yes ( ) No __________________________________________________________________________________________________________________ American LegalNet, Inc. www.USCourtForms.com Which of the following best describes your complaint (check no more than three): ( ) Inability to access OBS' website s ( ) Excessive delays in order processing and execution ( ) Inability to access real-time stock quotes ( ) Inability to access timely account status information ( ) Excessive delays in updating account information ( ) Inadequate customer service ( ) Inability to access customer service ( ) Inaccurate postings to account ( ) Unauthorized changes of account information ( ) Failure to provide best execution price ( ) Orders executed beyond purchasing power of account ( ) Single order executed multiple times ( ) Inadequate research available online ( ) Other: _______________________________________ Please provide a detailed description of your complaint:_____________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ Who referred you to this office?________________________________________________________________________________________ READ THE FOLLOWING BEFORE SIGNING BELOW: Please attach to this form COPIES of any papers involved DO NOT SEND ORIGINALS. NOTE: In order to resolve your complaint, we may send a copy of this form to the company about which you are complaining. In filing this complaint, I understand that the Attorney General is not my private attorney, but represents the public in enforcing laws designed to protect the public from misleading or unlawful business practices. I also understand that if I have any questions concerning my legal rights or responsibilities, I should contact a private attorney. I have no objection to the contents of this complaint being forwarded to the business or person the complaint is directed against. The above complaint is true and accurate to the best of my knowledge. I also understand that any false statements made in this complaint are punishable as a Class A Misdemeanor under Section 175.30 and/or Section 210.45 of the Penal Law. Signature:____________________________________________________________________ Date:______________________________ HAVE YOU ENCLOSED COPIES OF IMPORTANT PAPERS? Return completed form to: New York State Office of the Attorney General Internet Bureau 120 Broadway, 26th Floor New York, NY 10271-0332 American LegalNet, Inc. www.USCourtForms.com
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