Complaint Against WIC Store Contact InformationName*WIC staff need your information for following up, but you will remain anonymous. First Last Phone Number*Email Address* Describe Your ComplaintState all facts, including date and time of incident, name and location of store, name(s) of other(s) involved and witnesses, if any.Date and Time of Incident* Store Name and Number*Please include either the store number, address, and/or nearest cross-street to help identify chain stores. List the Name(s) of Staff InvolvedIf you don't have their name, a physical description can be helpful.What happened?Describe the Incident*Please provide as much detail as possible so that we can effectively follow up.Upload DocumentsSubmit documents that may be helpful to investigate this complaint (receipt, UPC, product label, etc.) Drop files here or Select files Accepted file types: jpg, png, pdf, Max. file size: 200 MB. CommentsThis field is for validation purposes and should be left unchanged.