Suspect a problem with a service station or a fuel pump? Fill out service station complaint form. * Required Fields Contact Information Your Name Title Title - None -MissMsMrMrsDrOther… Enter other… First Middle Last Suffix This information is confidential, but needed in order to ensure timely response to the complaint. Address Address City/Town Phone Email Address Station Information Station Name Date of Incident Station Address Address City/Town Near Cross Streets Pump Number Grade Fuel Type Receipt Scan One file only.100 MB limit.Allowed types: gif, jpg, jpeg, png. Comments: Store Information How did you find out about our consumer complaint forms? How did you find out about our consumer complaint forms? - None -Online Search Engine (e.g. Google)Community EventFriend, acquaintance, or coworkerBrochure/Flyer“Attention Consumers” Yellow StickerOther… Enter other… Leave this field blank