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The purpose of this form is to express all of the facts, allegations, information, data and documentation concerning your complaint about a member of the NATB. You may be entitled to compensation if a decision is made in your favor. Either party involved has the right to an appeal, as outlined in the NATB Complaint Procedures.

Today's Date_____________   Date of Purchase____________

Name of Event_________________________ Event Date__________ Event Time________

Amount Paid Per Ticket $__________ Quantity of Tickets ________

Method of Payment (circle one)  Cash  Credit Card  Check  Trade    Other(specity)________________

Name of the Broker complaint is about_______________________________

Did you receive tickets from broker  yes   no  If yes how were the tickets delivered?____________

What is the name of the person you spoke with at the Company? __________________________

What is the nature of your complaint? (continue on reverse side if needed):

Your Name______________________________  Address___________________________________

City___________________________________   State__________  Zip________________

Home Phone (_____)_____________________     Work Phone (_____) __________________

Thank you for taking the time to fill out this form. The Broker will have a chance to reply in writing and the complaint committee will make a determination that will be forwarded to you. Please include a copy of any receipts, supporting documentation, or contracts that you may have. By signing this form I also waive the confidentiality of information and documentation provided and I understand that any information or documentation may be provided to concerned parties including but not limited to members of any panel reviewing this complaint, the accused member, potential witnesses and members of the board of directors of the NATB.

Complainant Signature___________________________

National Association of Ticket Brokers (NATB)
214 N. Hale Street | Wheaton, IL 60187
Phone: 630-510-4594 | Fax: 630-510-4501
info@natb.org | www.NATB.org