Robert F. Brennan APC.






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Lemon Law
Questionnaire

If you feel you may have a Lemon Law / Auto Fraud case and would like an attorney to look at the case, we have provided the below form for your convenience.

IMPORTANT NOTE: Robert F. Brennan is licensed to practice law in the State of California only and cannot give legal advice regarding any case in any other state. Please see LINKS for information on attorneys in your state if you are not in California.

Please fill out the following form:
(Email Address and detail of specific request required for response.)

Email Address:
First Name:	Initial:
Last Name:
Daytime Phone:	Ext:
Evening Phone:
State of Residence:
Referred By:

Year of Vehicle:
Vehicle Make:
Vehicle Model:
Purchase Date:
Vehicle was purchased as:	New Used
Mileage When Purchased:
Current Mileage:
Purchase Price:
Dealer Name:
Warranty/As Is:	Warranty As Is
Business Use %:
Accident Damage:	Yes No If Yes, Amount?
Describe Vehicle's Problem:
Number of Repair Attempts:
Does Condition still Exist?	Yes No
Date of Last Repair Attempt:

Auto Fraud Type:	Undisclosed Collision Damage Odometer Rollback Used Car Sold as New Other:
Other Notes or Comments:

After you have completed this form, Or erase and all selection(s).

3150 Montrose Avenue, La Crescenta CA 91214
1-888-453-6665
Voice: (818) 249-Law1(5291)
Fax: (818) 249-4Fax(4329)
Email: rbrennan@brennanlaw.com
Office: info@brennanlaw.com