Transportation Complaint Form

If you would like to submit the information below by mail, you can print a pdf version of the form here. Once you fill out the form, please mail it to the address below.

Nebraska Public Service Commission

Transportation Department

PO Box 94927

Lincoln, NE 68509

Complaint Reported By

First Name: Required

Last Name: Required

Address: Required

Address:

City/Town/Village: Required

State: Required

Zip: Required

Daytime Phone: Required

Home Phone:

Email Address:

Do you hold a current Certificate of Authority?

Name of Company:

Preferred Method of Correspondence: Required

Have you contacted the business/person regarding your complaint? Required

Have you contacted an Attorney about your complaint? Required

Complaint Against

Name of Carrier: Required

Address: Required

Address:

City/Town/Village: Required

State: Required

Zip: Required

Daytime Phone: Required

Home Phone:

Person You Dealt With:

Complaint Issue:

Date of Occurrence:

Location:

Amount Billed:

Actual Payment:

Description of the facts in the complaint: Required

Describe the resolution you are seeking: Required

Please upload any supporting documents
Total file size for all files cannot exceed 17MB. (pdf, xls, xlsx, doc, docx, jpg, png, gif, tiff, txt)

Options:

The information given above is true to the best of my knowledge and belief. I authorize the Nebraska Public Service Commission’s office to send this complaint form to the company or to the interest parties and to use the information given in any manner which is determined necessary.

I have read and agree to the disclaimer text

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