Military and Veterans Assistance Program

Military Veterans Assistance Program Form

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This completed form will route your inquiry or complaint to the Attorney General's Office. Please complete all required fields, click on the "I Agree" button, then click the "Submit" button.

Fields marked with an asterisk (*) are required


*Are you filing this complaint on behalf of yourself or someone else?

SubmittedOnBehalfOf - To be hidden:
☑ Self
On behalf of someone else

*Affiliation with, or relationship to, the complainant?

AffiliationWComplainant - To be hidden:
☑ Dependent
Base Representative
Other
Federal or State Agency
Veterans Service Representative

*You selected Other, please explain here:



*You selected above that you are completing this form on behalf of someone else.

Please enter your contact information.



*Your First Name*Your Last Name
*Address
*State*CityZip Code
*Phone Number
(#'s only; no dashes, no spaces)
*Email Address
*Confirm Email Address



Complainant contact information

Penalties can be enhanced for victimizing individuals over the age of 60.
MVOver60 - To be hidden:
*Are you 60 or older?
Yes, 60 or older
☑ No


Penalties can be enhanced for victimizing active duty military, veterans, or their dependents.
MVMilitaryStatus - To be hidden:
*Your Military Status?
Active Duty
Reserve
Veteran
Dependent
Other

*You selected Other for Military Status, please explain here:



*First Name*Last Name
*Address
*State*CityZip Code
*Phone Number
(#'s only; no dashes, no spaces)
*Email Address
*Confirm Email Address



Complaint information

*What is this complaint about?
ComplaintCategory - To be hidden:
Benefits
Charity/Non-Profit
Debt and Credit
False Affiliation/Stolen Valor
Housing
Other

*You selected Other, please explain here:


*Name/Firm/Company Name
Street Address
StateCityZip Code
Phone
(#'s only; no dashes, no spaces)
Website

PdOrDonateMoney - To be hidden:
*Did you pay or donate money?
Yes
No
*Date of Transaction
*Amount Paid/Fee
*Payment Method (Select all that apply)
Cash
Check
Cashier's Check
Credit/Debit Card
PayPal
BitCoin
Wire Transfer
Other

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*You selected Other, please explain here:
*Description of Complaint
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Acceptance

I understand that your office does not give legal advice. I am filing this complaint to notify your office of the activities of this company so that it may be reviewed for appropriate action.

*You must click the "I Agree" button before you click on the "Submit" button.

I Agree
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Note:
  1. All documents and attachments submitted to this agency are subject to public inspection pursuant to Chapter 119, Florida Statutes.
  2. Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his official duty shall be guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082, s. 775.083, or s. 837.06 Florida Statutes.


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