Consumer Response Intake Form

The Intake Form is designed to aid the public in the submission of complaints, inquiries, and feedback to the CFPB and to help the CFPB fulfill the aforementioned statutory requirements. Consumers who wish to submit complaints, inquiries, and feedback may submit relevant information using the CFPB’s website where they will find an online version of the Intake Form. Alternatively, they may submit information by telephone and mail using the Intake Form. The Intake Form’s various fields prompt respondents for a description of, and key facts about, their complaints, underlying products and issues, the companies that are the subject of their complaints, and any previous action taken on their complaints. Responses to the Intake Form’s questions help provide the CFPB and the company with the information needed to contact the consumer and/or the consumer’s authorized representative (if applicable), send the complaint to the company for response, and follow-up on the submitted complaint, inquiry, or feedback.

The latest form for Consumer Response Intake Form expires 2029-03-31 and is listed under ICR 202610-3170-001.

View the official OMB control history on Reginfo.gov.