Download Formal Complaint Form - Missouri Public Service ...

BEFORE THE PUBLIC SERVICE COMMISSION
OF THE
STATE OF MISSOURI
Name: ___________________________________ )
Complainant
)
)
vs. )
)
Company Name:____________________________ )
Respondent
)
Case No.
FORMAL COMPLAINT
Complainant resides at _____________________________________________
(Address of Complainant)
______________________________________________________________________
1. Respondent, ___________________________________________________
(Company Name)
of ______________________________________________, is a public utility under the
(Location of Company)
jurisdiction of the Public Service Commission of the State of Missouri.
2. As the basis of this complaint, Complainant states the following facts:
1

3. The Complainant has taken the following steps to present this complaint to
the Respondent:
WHEREFORE, Complainant now requests the following relief:
________________________
Date
________________________
Complainant’s Phone Number
_____________________________________
Signature of Complainant
_____________________________________
Complainant’s E-mail Address
Attach additional pages, as necessary.
Attach copies of any supporting documentation.
2