Submitted by:

Name(Required)
Address(Required)

Licensed Appraiser Seeking Complaint Against

Name(Required)
Business Address

Describe the incident that led to your application for complaint. Your complaint must include:

1. A citation of the specific section of 212 CMR 2.00 which was violated by the appraiser.


2. A statement of facts of the complaint, including the dates and times that the events occurred.


3. Attach copies of appraisals, correspondence and any other documents which detail the facts of the complaint.

Please note that all applications for complaints are examined to determine their factual basis.
The act of filing an application for complaint does not assure or imply that disciplinary action will be taken against the licensed appraiser.

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    I Affirm and verify under the pains and penalties of perjury that the information provided is true, correct, and complete to the best of my knowledge. I am aware that a penalty of perjury may be imposed as provided for under M.G.L. Chapter 268, ยง1A when a statement or declaration signed under the penalties of perjury is willfully false in a material matter. The Application for Complaint Form and any documents filed with it, may be subject to public disclosure pursuant to the Massachusetts Public Record Law.(Required)