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Complaint Form. This is a New Mexico form and can be use in Regulation And Licensing Department Statewide.
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New Mexico Regulation and Licensing Department
ALCOHOL AND GAMING DIVISION
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Public Comments and Complaints
The Regulation and Licensing Department Alcohol and Gaming Division works
closely with the Special Investigations Division (SID) of the state Department of
Public Safety to enforce the provisions of the Liquor Control Act. Violations of
the Act by liquor license holders can result in fines and/or suspension of the
license. Three violations within a 12-month period can result in revocation of a
liquor license.
We welcome public comments, either positive or negative, regarding liquor
license holders and their employees. Protecting the people of New Mexico from
the often tragic effects of underage drinking, DWI and alcohol abuse requires
the active support of all our citizens. Please help us by reporting when you
observe a licensed liquor establishment or its employees violating state law or
failing in their obligations to the community.
In filing a complaint, it is important that you provide us with as much
information as possible, so that SID investigators will be able to pursue your
complaint.
Your name: _______________________________________ Date: _____________
Your Street Address: __________________________________________________
City: ___________________________________ State: _________ Zip: __________
How may we contact you?
Phone: ________________________ E-mail: _________________________
We will respect your confidentiality. If you wish to remain anonymous, please check here:
_______________
The Liquor License Holder you wish to comment or complain about:
Business Name: _________________________________________________________________
Location: ______________________________________________________________________
Street: ____________________________________________ City: ________________________
Type of Business:
Bar ______
Restaurant ______
Package Goods Retailer: _______
Other: _______
Revision date: 02/2008
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www.FormsWorkFlow.com
Alcohol and Gaming Division
Public Comments and Complaints
Date of the Incident: ___________________
Summarize your comment or complaint (attach another sheet of paper if you need more space):
______________________________________________________________________________
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You may submit your comments or complaints on-line through the RLD website, or mail this form
to:
Regulation and Licensing Department
2550 Cerrillos Road
Santa Fe, NM 87505
Thank you for your help!
New Mexico Regulation and Licensing Department
ALCOHOL AND GAMING DIVISION
Page 2 of 2
Revision date: 02/2008
American LegalNet, Inc.
www.FormsWorkFlow.com