Vehicle Problem Questionnaire by Your Legal Justice / Stern Law, PLLC

Vehicle Problem Questionnaire by Your Legal Justice / Stern Law, PLLC
Thank you very much for contacting us. We would like to hear more about your issues in order to connect you with legal assistance to resolve the matter. Have questions? Call our offices at (844) 808-7529.

Thanks!

Your Legal Justice | Stern Law, PLLC
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
State Vehicle Was Purchased*
Vehicle Year*
Name of Vehicle (Make and Model, i.e. Ford Explorer)*
Mileage*
Purchased or Leased?*
Date Purchased/Leased*

MonthDayYear
Please provide brief descriptions of problems, repair attempts and days in the shop including Date and Summary of work done
Repair Info*
Should be Empty: