Consumer Complaint Portal: General Complaints, Obscenity or Indecency Complaints, Complaints under the Telephone Consumer Protection Act, Slamming Complaints, Requests for Dispute Assistance and Comm

Product: Internet

Approved by OMB 3060-0874 (Estimated average burden per person is 15 minutes.)

Email address

Subject

Have you contacted your provider about this issue? y/n

Internet issue (drop down)

Availability

Coverage areas/coverage maps

Additional charge to make service available

Amount of charge

Reason for charge

Estimated time frame to complete

No service available

Outside service area

Construction necessary

Other (use description field)

Billing

Service charges

Lifeline

Taxes/fees

Surcharge (including Universal Service)

Advertised rates

Other (use description field)

Equipment

Modems

Other (use description field)

Interference

Jamming/Blocking (including Wi-Fi)

Location/date/time

Other (use description field)

OI/Net Neutrality

Blocking

Data caps

Throttling

Inaccurate disclosures/Transparency

Other (use description field)

Privacy

Has your personal information been accessed, obtained or used by an unauthorized person? y/n

If yes:

Describe what personal information has been accessed, obtained or used

Describe how you discovered your personal information had been accessed, obtained or used

Did you receive written notice from your provider about the data breach? y/n

If yes, attach or describe the notice, include the date you received the notice and what it contained

Did you have previous security concerns about your provider?

Speed/Service quality

Less than advertised speed

Inconsistent speed

Other (use description field)

Internet method

Fixed Wireless

Mobile Wireless

Cable

Satellite

DSL

Fiber

Wi-fi

Company name (your provider)

Are you a current, former, or prospective customer of this company?

Current

Former

Prospective

Other

Have you contacted this provider about this issue? y/n

Have you filed a complaint about this issue in the past 90 days?

Account number

First name/Last name

Address/city/state/zip code

Phone (where you can be contacted)

Filing on behalf of someone

If yes, your relationship (on behalf of)

First name (on behalf of)

Last name (on behalf of)

Company name (on behalf of)

Address (on behalf of)

City (on behalf of)

State (on behalf of)

Zip code (on behalf of)

Description of complaint (free text field)

Can the FCC share your description of your complaint (minus PII) with the public on our website? y/n

Attachments