Professional Documents
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FORM No (Lemonlaw)
FORM No (Lemonlaw)
Repair
Attempts
Odometer
Reading
Date of Delivery
by Consumer for
Repair
Date of
Completion of
Repair
#1
#2
#3
#4
Vehicle Make: ____________________Model: _________________Year:________
Vehicle Identification Number: ___________________________________________
Name/Address of Selling Dealer:
________________________________________________________________________
__________________________________________________________________
Delivery Date: _______________Current Odometer Reading: ___________________
Repair
No.
Date of Repair
1
2
3
4
I am requesting that you make a final attempt to resolve the said complaint reported
above. My contact information is:
Name ______________________________Contact No.________________________
Address______________________________________________________________
Consumer signature _______________________Today's date __________________