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Auto Dealer Complaint Form

MAIA is initiating a new Dealer Complaint Procedure. Please complete the form below. MAIA will review your complaint with the dealer involved in an attempt to resolve the problem and avoid future occurrences. If you do not hear from us within 1 business day, please contact Kathy Cormier at
Please Choose the Action Requested:

Brief Explanation of Problem:

Agency Contact Person:
Agency Name:
Phone Number:
Fax Number:
E-mail Address:
Name of Dealer:
Name of Salesperson or Dealership Contact:
Phone Number:
Fax Number:
Name of Customer:
Vehicle Description: (Year/Make/Model)
Plate Type and Number:
Todays Date:
Todays Time: