Lemon Law Case Evaluation, Law Office of T. Michael Flinn

If you would like us to review your lemon law or auto fraud claim at no cost and no obligation to you, please fill out the following lemon law claim assessment form. Please enter carefully. We will need accurate information in order to contact you.

PERSONAL INFORMATION
Name
FirstLast
Email address*
Enter EmailConfirm Email
Address
Street AddressAddress Line 2CityStateZip Code
Phone Number*
Alternate Phone Number
Best time to call

VEHICLE INFORMATION
Year, Make and Model
Where did you purchase the vehicle?
Dealer's Address
Street AddressAddress Line 2CityStateZip Code
Date purchased
Purchase Price
Mileage at purchase
This vehicle was purchased/leased
- New
- Used
- Demo
If used, which of the following applies?
- As Is
- With Warranty
Current mileage
Preferred resolution
Please state IN DETAIL the most important problems you have with the car or the dealer (Ex: "The car had been wrecked and the dealer did not tell me or lied to me" or "The dealer sold me a car that will not pass emissions"): *

MAJOR AREAS OF CONCERN
Select all of the following that apply
- Drivetrain
- Suspension
- Electrical
- Body
- Interior
REPAIR HISTORY
Please list the SYMPTOMS that you have experienced with your vehicle, the number of trips to the dealer for each symptom (whether documented or not), and the date(s) when the vehicle was inspected and/or repaired for each symptom.
Symptom #1
Description of symptom
Number of trips to the dealer
Date(s) in repair shop
Symptom #2
Description of symptom
Number of trips to the dealer
Date(s) in repair shop
Symptom #3
Description of symptom
Number of trips to the dealer
Date(s) in repair shop
Symptom #4
Description of symptom
Number of trips to the dealer
Date(s) in repair shop
Symptom #5
Description of symptom
Number of trips to the dealer
Date(s) in repair shop
Symptom #6
Description of symptom
Number of trips to the dealer
Date(s) in repair shop

REPAIR ATTEMPTS
Total number of repair/work orders in your possession
Approximate total number of CALENDAR DAYS vehicle has been out of service and/or in the repair shop
ADDITIONAL DETAILS
Please provide any additional information you'd like to add.
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Free Case Evaluation

Step 1 of 4

PERSONAL INFORMATION

VEHICLE INFORMATION

MAJOR AREAS OF CONCERN

REPAIR HISTORY

Symptom #1

Symptom #2

Symptom #3

Symptom #4

Symptom #5

Symptom #6

REPAIR ATTEMPTS

ADDITIONAL DETAILS

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