Consumer Compliant Monitoring System

Consumer Complaint Monitoring System-Food Safety Mobile Questionnaire

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0583-0133 can be found here:

Document [pptx]

Download: pptx | pdf

1 or 2 “No” Responses to Pre-Qualifying Questions

Step 1 – Nature of Complaint

Step 2 – Identification of Product

Step 3 – Name and Location of Store Where Purchased

Step 4 – Product Usage

Step 5 – Illness/Injury Details

Step 6 – Personal Information

Submission Confirmation

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