Complaint Form | State Board of Technical Registration

The captcha on this page is case sensitive. This Webform does not save information typed in if the Webform fails prior to submission. The Board suggests typing up your response in a word document, or equivalent, before entering it here.

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.

The Board has the statutory authority to issue restitution (for the cost of a home inspection or an engineering report, etc.). Restitution is not the same thing as Damages. Damages could be received by pursuing a cause of action in Justice or Superior Court.

Please do not submit original hard copy records or documents with your complaint. All such records and documents submitted to the Board become part of the investigation file and will not be returned. Please only submit copies.

Please be aware that once you file a complaint, the complaint will proceed according to the Board's statutes and rules.

Jurisdiction

Pursuant to ARS 32-106(C), “the board may investigate a complaint pursuant to subsection A, paragraph 5 of this section and may take any necessary disciplinary or enforcement action resulting from a complaint only if the complainant either:

1. Currently has a contractual relationship with the person who is the subject of the complaint or had a contractual relationship with the person at the time of the alleged misconduct.

2. Was harmed by the alleged misconduct or possess firsthand knowledge of the alleged misconduct. For the purposes of this paragraph, “firsthand knowledge” includes knowledge of the outcome of the misconduct, witnessed by a person with relevant professional experience in the course of that person’s contractual duties with the harmed individual.”

Please check one or more boxes that apply:

I currently have a contractual relationship with the person who is the subject of the complaint or I had a contractual relationship with the person at the time of the alleged misconduct.

I was harmed by the alleged misconduct.

I possess firsthand knowledge of the alleged misconduct. For the purposes of this paragraph, “firsthand knowledge” includes knowledge of the outcome of the misconduct, witnessed by a person with relevant professional experience in the course of that person’s contractual duties with the harmed individual.

Please explain your selection further:

Allegations/Complaint

Pursuant to 32-106(A)(5), the board shall “Hear and act on complaints or charges that are specified by the complainant or direct an administrative law judge to hear and act on complaints and charges that are specified by the complainant.”

I understand that the Board can only hear and act on allegations or charges that I specify in my complaint.

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. Acceptance of the complaint may be subject to an intake interview by an investigator. Please review the statutes, rules and standards enforced by the Board to ensure that you provide sufficient information and to ensure that the allegations are of a law within the Board’s jurisdiction. You may call (602) 364-4930 to request to speak to someone in the Enforcement Unit with any questions.

Your Information

Your Name

Home Phone Number

Cell Phone Number

Fax

Email

Mailing Address

City

State

Zip

Business Name

Business Phone

Subject of the Complaint

Name of individual you are complaining about

Name of Company

Individual’s profession (if applicable)

AZ Registration # (if applicable)

Address

City

State

Zip

Email

Work Phone

Home phone

Website Address

Project Name and Location

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 name

Address

Phone

Witness 2

Witness name

Address

Phone

Is part of your complaint based on the fact that the individual you are complaining about is not licensed appropriately? You can check if an individual is licensed here and if a business is licensed here.

Is part of your complaint based on the fact that the individual you are complaining about is not licensed appropriately?

Yes

No

Description of Your Complaint (Allegations and Charges)

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. Please review the statutes, rules and standards enforced by the Board to ensure your allegations correspond to a violation of the Board’s practice act.

You may call (602) 364-4930 to request to speak to someone in the Enforcement Unit.

Complaint Description

Attachments

If you have more than 10 files to include, please submit a second form.

File 1