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Find out if you have a case - NOW!

Get a reply in 1-2 hours and it's absolutely FREE!

Contact Information:

First Name:    Email:   

What do you seek to resolve your “lemon” situation?

Manufacturer buy back (repurchase) my vehicle and refund my money
Manufacturer replace my vehicle with a brand new one

 Information on your vehicle:
(Please use the “tab” key and complete each of the blank boxes)

Year:    Make:    Model:

Transmission Type:  

Information on acquiring your vehicle:
 
(Please use the “tab” key and complete each of the blank boxes that apply to your vehicle)

Vehicle purchased/leased NEW?  Vehicle purchased/leased USED?

If  “Used”, was it a mfg’s “certified pre-owned” used car?
Yes  No

Leased?      Purchased?

Name of delivering dealership: Delivery date:

Miles at delivery: Present miles on odometer:

Symptom/Defect/Repair Attempt Information:
(please use the “tab” key and complete each of the blank boxes that apply to your vehicle)

PLEASE NOTE:  This section deals with “repair attempts”.  A “repair attempt” is defined as when you present your vehicle to a franchised new car dealership, have a repair order written with your stated complaint so that you have a copy, in writing. Example: “customer states transmission slips”.  Simply verbally “telling” a Service Advisor about the problem/symptom without it being written on the Repair Order does not count as a “repair attempt”.

Problem Area(s) 
( Please check all that apply )

Repair Attempts

Engine mis-fire/ rough running Select #:
Engine “stalls” Select #:
Engine “knocks” Select #:
Engine loses power Select #:
Engine won't start Select #:
Engine has extended “crank time” Select #:
Fuel vapor smell Select #:
Inaccurate fuel gauge Select #:
“CHECK ENGINE” warning lamp Select #:
“SES” warning lamp Select #:
Engine overheat or red warning lamp Select #:
“Low Oil” warning lamp Select #:
Transmission issues (automatic) Select #:
Transmission issues (manual gearbox) Select #:
Clutch Select #:
Rear differential/rear axle Select #:
Driveline/driveshaft Select #:
Brakes (excessive wear) Select #:
Brakes (rotors warping/brake pulsation) Select #:
Brakes (loss of braking) Select #:
“ABS” warning lamp Select #:
“SRS/Air Bag” warning lamp Select #:
Other dash warning lamp illumination Select #:
Steering problems (wander, “popping”, etc.) Select #:
Power steering noises Select #:
Air conditioning (doesn’t get cold) Select #:
Heating system (doesn’t get warm) Select #:
Water leaks into interior or trunk Select #:
Suspension (creaks/knocks/popping) Select #:
Power windows (failure to operate) Select #:
Alarm system* (factory alarm) Select #:
Convertible top operation or water leaks Select #:
Electronic air suspension Select #:
Steering “shimmy” after repeated wheel/tire balancing Select #:
Instrument cluster malfunctions/lighting goes out Select #:
“Service Stability” system warning lamp Select #:
Other: Select #:

About your new vehicle:

Did the dealer install a non-factory alarm before delivery? Yes   No

Did the dealer add any accessories? Yes    No

What accessories did the dealer add before you took delivery?
 

If acquired new,  did the vehicle spend 30 or more days in the shop before it reached 18 months old, or 18,000 miles on the odometer? Yes   No

About the current condition/operation of the vehicle:
(Please use the “tab” key to the box below and type in what current problems you are having with the vehicle, and if they can be readily reproduced, or are “intermittent” in nature.)

Brief details of your contact with the auto manufacturer (if applicable):
 

Have you called the “customer assistance 800 number” and complained? Yes    No  
  
Did you receive a “case number?”
Yes    No

Have you filed for arbitration? (NOT required in California) Yes   No

Have you already been through arbitration? Yes    No
(if "yes", then what was their decision?)
 

Congratulations! Upon clicking the “Submit Form” button below,
you will receive an e-mail response within 1-2 hours!

Call anywhere from California: 1-800-CA-LEMON (1-800-225-3666)

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