Case Details Form

The Lemon Law is very favorable to consumers. The first step towards settling your case is to find out if you qualify for it. Please take a few minutes to provide us with the information on this form, or call us for a telephone interview (toll free: 1-877-768-7227). This information will enable us to evaluate your situation and provide you with guidance. (* Required)

Personal Information

First Name:

Last Name:

Address:

City:

State:

Zip:

*Home Phone:

*Work Phone:

*E-Mail:

If my case qualifies under the law, I would like to get a:

Vehicle Details

Year:

Make:

Model:

Current Mileage:

Selling Dealer:

Dealer City:

Dealer State:

Purchase/Lease Date:

This vehicle was purchased/leased:

Defects & Nonconformities

In the spaces provided below, please list the problems you have had with your vehicle and the approximate number of days the vehicle has been in the shop for each problem.
Problem Days in the shop

1.

2.

3.

4.

5.

6.

Total number of calendar days the vehicle has been out of service and/or in the repair shop:
Additional Comments:

 
Song-Beverly Consumer Warranty Act: California Lemon Law
 
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