Headquarters Office
12300 Lower Azusa Road
Arcadia, CA 91006-5872
(626) 575-5471

South Gate Office
11012 South Garfield Ave.
South Gate, CA 90280
(562) 622-0402

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Store Scanner
Complaint Form

Last Updated: 03/12

You can send us a consumer complaint by using the form below. If your browser does not allow you to view the forms, send us an e-mail message at:

Be sure to include all of the relevant information below.

Date of occurrence:
-  (The date you shopped at the store)
On what item were you overcharged?:  (The product, brand & package size) 
What was the shelf price? $ .
What was the price at the check-out stand? $ .
Was this a sale item?
Yes   No
How was it advertised?
Store Flier   Newspaper   Radio   Other

Store Information
(*) Indicates required fields

* Store name:
City:     State: CA
 Zip Code:
* Cross Streets: (i.e., Street/Avenue)
Would you like us to contact you with our results?: Mail   E-mail   Phone   No, thanks

Personal Information

Home Address:
City:     State:
 Zip Code:
Telephone Number:  )      (XXX) XXXXXXX