Complaint Form

Please note that a copy of this complaint could be provided to the individual(s) involved in your complaint. Also, you could be called to testify as part of a formal or informal proceeding, such as a hearing. Complaints filed with the Arizona Board of Technical Registration are subject to the Public Information Act. In most cases, the Board must disclose the information you provide on the complaint form to any person who requests it, including the person against whom you are filing this complaint. If you have any concerns about the disclosure of your personal information (name, address, etc.), please contact the Board before you file this complaint form and we can discuss it with you.

Your Information
Subject of the Complaint
Please provide the information below regarding persons who can help provide information related to the alleged violation(s) you are reporting in this complaint:
Witness 1
Witness 2

Please note that upon receipt of a complaint, the Board will conduct a preliminary evaluation of the matter to determine whether allegations described in your complaint are within the Board’s jurisdiction. Please review the statutes and rules enforced by the Board on our Website to ensure that you provide sufficient information and to ensure that the allegations are of a law within the Board’s jurisdiction (www.azbtr.gov). You may call (602) 364-4930 to request to speak to someone in the Enforcement Unit.

Be specific. What happened? Who was involved, including city or county agencies (provide names, addresses and phone numbers)? Provide dates and details / timeline of events. Clearly describe each alleged statute and/or rule violation separately and enclose copies of any documents from any sources which will support your allegations. Include the date the incident(s) occurred and the address of the location where the incident(s) occurred.
Attachments
If you have more than 10 files to include, please submit a second form.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx avi wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx avi wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
More information
  • Files must be less than 30 MB.
  • Allowed file types: gif jpg jpeg png txt rtf pdf doc docx xls xlsx mp3 wav.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.