LEMON LAW QUESTIONNAIRE


1. Name:

2. Address:

3. Telephone Numbers:

   Home:


   Work:                       (between ___________ and ___________).


4. Occupation:


5. Did you purchase or lease the vehicle?


6. Vehicle purchased/leased (year, make and model):



7. Name and address of selling dealer:




   Name and address of dealers who have repaired or attempted
   to repair your vehicle:




8. Date of purchase/lease and delivery:


9. Mileage at time of purchase/lease:


10. Purchase price (or capitalized cost if a lease):


    (a) Did you finance your vehicle?


    (b) If so, through whom?



    (c) Was financing arranged through the selling dealer?



11. Length of original manufacturer's warranty (excluding
    "extended warranties" or "service agreements"):



   (a) Did you purchase, in addition to the original
       manufacturer's warranty, an "extended warranty" or
       service contract?  If so, is it issued by the manufacturer 
       or by some independent company?


   (b) If so, what is the length of this coverage?





12. Do you have copies of all work orders for repairs performed on
    your vehicle? (you should get these from the dealers if possible)




13. Did you buy the vehicle for (1) personal use only, for (2) business 
use only or for (3) personal and business use?




14. During the first 18 months or 18,000 miles, whichever occurred
    first:


    (a) Was the vehicle out of service for repairs for more than
        30 days?




    (b) Was the vehicle in for repair of the same problem(s) 4 or
        more times? If you have a safety-related problem, was
	it in for repair 2 or more times?  If so, what problem(s)?


















15. What is the current mileage on the vehicle?


16. If the vehicle is not currently in your possession, please
    explain why.














17. Briefly describe the current problems you are having with your
    vehicle.






















18. Briefly describe your efforts to resolve these problems with
    the dealer and manufacturer (including arbitration if you have
    submitted your complaint to arbitration).








































19. How did you learn that our office represents consumers under
    the lemon law?



























































                             LEMON CHECKLIST


     Please return this completed checklist along with your lemon law
questionnaire and documents.  Explain why you are not sending any of
the itemized documents where indicated at the bottom of this page.

     ORGANIZE YOUR DOCUMENTS IN CHRONOLOGICAL ORDER BEFORE SENDING
THEM TO US.  DO NOT SEND YOUR ORIGINAL DOCUMENTS.  HAVE YOUR
ORIGINALS COPIED AT A PHOTOCOPY CENTER SO THAT ALL COPIES CAN BE 
READ. BE ESPECIALLY ALERT AS TO REPAIR ORDERS WHICH ARE TYPICALLY 
VERY DIFFICULT TO READ.  COPY THESE AS DARK AS POSSIBLE.


    Document                                          Enclosed
                                                    Yes       No

1.  Purchase Agreement                              ___       ___

2.  All Repair Orders(1)                            ___       ___

3.  Correspondence                                  ___       ___

4.  Arbitration Documents(2)                        ___       ___

5.  The original manufacturer's warranty            ___       ___
    (a booklet)

6.  Any extended warranty or service agreement      ___       ___
    (this is a separate document from your
    warranty)

7.  Notes you may have made (i.e., during           ___       ___
    telephone calls)

8.  Copies of all DMV renewal notices and/or        ___       ___
    cancelled checks, reflecting the full
    amount of DMV fees paid on this vehicle
    from the time of purchase.

9.  Copies of all insurance premium statements      ___       ___
    paid on this vehicle from the time of
    purchase.

--------------------------

(1) If you do not have a repair order for each time your vehicle was
serviced, you should try to get these from the repairing dealer.  If 
you need to do this, you should ask the secretary/receptionist at
the dealership for a copy of your file.  If you need to explain why,
you can tell them that you need it to discuss matters with the
manufacturer's representative or that you need it to submit to the
manufacturer's arbitration mechanism.

(2) If you have gone through arbitration, you should get a complete
copy of your arbitration file to send on to me.  Arbitration
mechanisms are required to give you a complete copy of your file for
a minimal cost.


--------------------------


10. Copies of any documents reflecting repairs      ___       ___
    or maintenance performed on this vehicle.

11. Copies of any documents reflecting towing       ___       ___
    or storage charges you have incurred.

12. Any documentation of lost wages incurred as     ___       ___
    a result of the problems with your vehicle.

13. Documentation of any additional equipment       ___       ___
    which you have added to the vehicle.

14. A statement of the number of days your          ___       ___
    vehicle has been out of service for repairs
    and for which you have not received a loaner
    vehicle or rented a vehicle.

15. Copies of any documents reflecting charges      ___       ___
    for vehicles you have rented as a result
    of yours being out of service.

16. A summary of the loan payments you have         ___       ___
    made on your vehicle (dates and amounts)
    together with the name, address, and
    telephone number of your lender, your
    account number and social security number.
    I will also need the current payoff amount
    (which you can get from the lender).

17. A copy of your current registration.            ___       ___

18. The completed "Lender Authorization" sheet      ___       ___
    (attached).

    Explanation for documents not included:





























                             LENDER AUTHORIZATION


Name of Lender:


Address of Lender:


Telephone Number
of Lender:


Contact Person
for Lender:


Name(s) on this
Account:


Account Number:


Social Security
Number:


     I hereby authorize my above lender or lessor to release
information on my above account including, but not limited to,
payment history and payoff information, to my attorneys, Clarkson
& Boatman.


Dated: ______________________     _______________________________
                                  Signature



                                  _______________________________
                                  Signature