Your Full Name:
**

E-mail:
**

Street Address:
**

City:
**

State:
**

Zip Code:
**

County of Residence:
Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur DeKalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hancock Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Jennings Johnson Knox Kosciusko LaGrange Lake LaPorte Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush St Joseph Scott Shelby Spencer Starke Steuben Sullivan Switzerland Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley

Home Phone (incl. area code):
**

Office/Work Phone (incl. area code):

Cellular/Pager

Best time to contact you:
**

Utility Company:
**

Is the account in your name?
Yes No **

If not, whose name appears on the bill?

Does the account use the address noted above?
Yes No

If not, what address appears on the bill?

Please describe your problem as briefly and as clearly as possible (If your complaint involves telephone service, specify the number in question):**

Have you contacted the utility about the problem?
Yes No **

If so, what has the utility done?

What would you like the OUCC to do on your behalf?

Note: The OUCC will not voluntarily share your information (including your name) publicly, unless you wish otherwise. However, the agency may be compelled by a court or regulatory body to produce copies of complaints under the Indiana Access to Public Records Act (IC 5-14-3-1 et.seq.).

If you do not object to your information being voluntarily shared with the news media or other requestors, click here:

If you do object, click here: