Texas Department of Licensing and Regulation

File a complaint

Complaints must be filed within two years of the event giving rise to the complaint.

In the event an investigation is opened Enforcement procedures require a copy of the complaint and all associated documentation to be forwarded to the Respondent including your name and contact information.
If you wish to file your complaint anonymously to ensure your identity is not revealed, you must leave your information, the complainant, blank. If you file the complaint anonymously, you will not receive automated status updates.

For TDLR to pursue an investigation of your complaint, please attach all documentation and information related to your complaint.
Please provide as much information as possible. If your complaint does not contain enough information for TDLR to decide that a violation has occurred, your complaint may not be opened for an investigation.

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Select a TDLR program*

Date of incident:*

1. Did the service result in an injury requiring medical attention or death?*

2. Does this report involve fraud, financial loss or property damage of more than $7,500?*

3. Is this a report that involves Human Trafficking?*

Description of incident:*

Please attach any documents with additional information if the incident detail description will be more than 1,000 characters.

Responsible Party: Provide information about the person or business you are complaining about, the Respondent

Respondent Name:*

License #:

Company name:

Street address:*

Street address Line 2:

City:*

State:*

Zip Code:

Phone:

Email:

For Motor Fuel related complaints, please enter:

Gas station pump number:

Fuel Grade:

______________________________________________________________________________________________________________________________________________________

Provide information about yourself, the Complainant.

Do you want to remain anonymous?

If you check “Yes” to submit your complaint anonymously, then do not complete the bottom portion of this form.
By submitting your contact information, your information may be subject to release through an Open Records Request under the Public Information Act, Chapter 552 of the Texas Government Code.

Yes

If you do not provide a mailing address, the Department will not be able to send you periodic updates concerning this complaint.

Complainant First name:

Complainant Last name:

Street address:

Street address Line 2:

City:

State:

Zip Code:

Email:

Phone:

Attachments

Please attach any supporting documentation you have relating to your incident, including: receipts, invoices, picture, etc. Color images are encouraged.

Attachments (BMP, DOC, DOCX, GIF, JPEG, JPG, PDF, PNG, TIFF, XLS, XLSX)**

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