Tennessee Regulatory Authority (TRA)
Chairman Jim Allison, Executive Director Earl Taylor

Yes No Yes or No Required. Choose Yes or No. My telephone number is registered with the TN Do Not Call Register.

If you answered No, do not continue with this form. Please call 1-877-872-7030 to register.

First Name* Required. Initial Last Name* Required.

Address* Required.

City* Required. County* Required. Zip* Required. Invalid.

Home Phone #* AC 423 615 731 865 901 931 Required. Invalid. Required. Invalid. Work #

Home # Solicited* AC 423 615 731 865 901 931 Required. Invalid. Required. Invalid. Your E-Mail* Required. Invalid.

Name of Telemarketer complaint is against* Required.

Date of Call* Required. Invalid. Use mm/dd/yyyy TIME Invalid. Caller-ID # Invalid.

Caller's Call-Back # Invalid. Product/Service Offered* Required. Min 30 Max 60

Caller First Name Caller Last Name

Caller Address Required.

Caller City Caller State Caller Zip

*1. The call was from a live person. Yes No Yes or No Required. Choose Yes or No.

*2. The call was a prerecorded message. Yes No Yes or No Required. Choose Yes or No.

*3. Solicitor number obtained by Caller-ID and listed above. Yes No Yes or No Required. Choose Yes or No.

*4. I have retained the Caller-ID number or recorded message. Yes No Yes or No Required. Choose Yes or No.

*5. I have a business relationship with the calling solicitor. Yes No Yes or No Required. Choose Yes or No.

*6. I would be willing to testify in court regarding this complaint. Yes No Yes or No Required. Choose Yes or No.

Please briefly describe your complaint.

Please check the box to give the TRA permission to obtain your telephone records. Yes* Required.

DATE* Required. Invalid. Use mm/dd/yyyy