Fraud Complaints - Jordan Ayarr Agency

Fraud Complaint

Your responses are voluntary but would be useful in the investigation and prosecution of this matter. You may be contacted by a special agent and asked to provide additional information

As the victim of a fraud crime, you may suffer financial and emotional harm and even medical problems relating to your victimization. And you are not alone. Thousands of people are victims of fraud crimes each year.

Name:

First

Last

Email *

Your Phone Number *

Your Subject *

Your Address *

Your Business *

Your City

Your State

Your Country

Zipcode/Postal code

It's been ________ since my last complaint:

Days
Weeks
Months

I am:

Fairly Perturbed
Pretty Annoyed
At My Wit's End

You are:

In Hot Water
On Thin Ice
Tempting Fate

Dates of first communication (provide full details) *

Platforms of communication (means of interaction)

Social Information (social username or email)

What did you believe you were paying for?

Who did you believe you were paying?

How much did you pay?

What was your method of payment?

What were you promised for your payment?(provide full details)

Did you suffer any regulatory loss? (if yes, give full details)

Are you still in contact with the defrauder(s) (if yes, provide full details)

What action have you taken? (if any, provide full details)

Did you report to any enforcement agency? (provide full details)

Has a Police report been filed? (provide full details)

Fraud Complaint

*Your responses are voluntary but would be useful in the investigation and prosecution of this matter. You may be contacted by a special agent and asked to provide additional information*

Your responses are voluntary but would be useful in the investigation and prosecution of this matter. You may be contacted by a special agent and asked to provide additional information