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Specifications
Model Year:*
Manufacturer:
Model:
Current Mileage:
Purchase Month/Year:
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Purchase Mileage:
Purchase Type:
Dealer:
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Situation Details
| Have you been in for repair 3 or more times for any ONE problem?* |
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| Has the vehicle been in the shop for more the 30 days total for all problems?* |
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RV Type:
Total Number of Repairs:
Total Number of Days in the Shop:
- Engine/Chassis Batteries/Alternator
- Brakes/Steering/Suspension/Axlse
- Interior/Exterior Fit & Finish
- Coach Heating or Cooling System
- Chassis Electrical System
- Plumbing
- Appliances
- Frame
- Slide Outs/Leveling System
- Generators/Coach Batteries
- Fluid Leaks
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RV Specific |
How many miles have you spent driving to get repairs?
Do you have any drivability issues (wandering, pulling) with your motorhome?
If you have drivability problems are they current or prior problems?
Are there gaps/air leaks in the body?
Have you experienced any vibrations or shaking of the unit?
If you have vibration or shaking, are they current or prior problems?
Additional Information?
List the states where repairs have been made.
Do you have any other concerns related to the purchase or repair of your vehicle?
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Other comments:
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Contact Information |
First Name*
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Last Name*
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Phone: (999-999-9999)*
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Preferred Contact Method:
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Email:
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Preferred Contact Time:
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State of Residence:*
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Submitting this form does not establish an attorney/client relationship – that will be established only upon our mutual agreement and execution of an attorney client contract with the law firm to whom your inquiry/submission is referred. As such, information sent in a request for a brochure/information may not be kept confidential and may not be protected by the attorney/client privilege, however, any such information will not be disseminated in any way or for any purpose other than that stated above.
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