State of Mississippi Motor Vehicle Commission
  Today is:

  Complaint



MISSISSIPPI MOTOR VEHICLE COMMISSION
COMPLAINT FORM
This is the official form for filing a complaint with the Mississippi Motor Vehicle Commission.
The nature of the complaint should be clearly and thoroughly stated.
Complainant Information:
  Name:
  Address:
  City, State Zip:
  Work Phone:
  Home Phone:
     
Mailing (If Different)
  Address:
  City, State Zip:



   


Dealer Information
  License No.
  Dealership Name:
  Owner/Manager:
  Dealership Address:
  City, State Zip:
  Business Phone:
     

Name of Person With Whom You Dealt: 
Vehicle Purchased: Model (Year/Type):
Manufacturer: VIN Number:
Date of Purchase: Amount Paid:
Amount Financed Date Of Your Last Contact With Business
With Whom Did You Speak? His/Her Title?
       


Do you know of others with similar complaints against this company?

Name 1: Contact Address:
    City:
    State:
    Zip:
       
Name 2: Contact Address:
    City:
    State:
    Zip:
       


Summary of Complaint (Briefly describe your complaint. Include specific dates.):



   
Uploaded Documentation:
Electronic/Scanned documentation must be added from the complaint update screen.
 
   
Have you retained a private attorney regarding this matter?

   
   

State of Mississippi Motor Vehicle Commission
1755 Lelia Drive, Suite 200
Jackson, MS 39216
601-987-3995
Fax: 601-987-3997
Transparency Mississippi Management and Reporting System

Link to Adobe Acrobat Reader