About This Form

This form is provided by the Kansas Department of Insurance to help individuals report securities violations, fraud or misconduct in the financial markets.

Important Information

Before filing a complaint, please contact your broker-dealer or investment adviser to confirm your concern is not considered a typical market loss on an investment.

If your concern falls within the jurisdiction of the Kansas Department of Insurance, Securities Division, please provide accurate and detailed information to help us investigate your complaint thoroughly.

Alternatively, if you would rather fill out a paper complaint and mail or fax to our office, please download the Securities Complaint Form or Formulario de Quejas del Consumidor.

File Complaint Online

Free viewers are required for some of the attached documents.
They can be downloaded by clicking on the icons below.

Acrobat Reader Windows Media Player Word Viewer Excel Viewer PowerPoint Viewer