LEMON LAW COMPLAINT FORM
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1 'lc vas Motor Vellicics Instructions: LEMON LAW COMPLAINT FORM Forms submitted incomplete and/or without the attachments listed below may cause a delay that could result in your complaint being rejected due to untimely filing. Return this form with the following attachments: twl) Purchase order or sates contract. L4) Repair Order(s). /3) Copy of written notice to manufacturer, converter and/or distributor. rik4) Extended service contract, ii applicable. /45) Lease agreement, if applicable. 6) Other relevant information. if you are seeking repurchase or replacement of your vehicle, along with the attachments you must include a 835 filing fee. You can submit the tee by check or money order payable to the Texas Department of Motor Vehicles. Do not mail cash. Send to: Texas Department of Motor Vehicles, PO Box 13044, Austin, TX If you are seeking repairs only, send this form and the requested attachments to: Texas Department of Motor Vehicles, 4000 Jackson Ave., Austin, TX OWNER: 1-e_)Lis.'cJ tet MAILING ADDRESS: _143 tif te) CITY: STATE: MN_ WORK PHONE: <--) 8 yl HOME PHONE: S et n4-0 ADDRESS: ZIP: FAX: pi L- ro LLC RECEIVED FEB rum DEPARTMENT ofivor VEHICLES MOTOR VEHICLE DIVIStOid CHECK ALL THAT APPLY: NEW El USED EI DEMO 0 PROGRAM E LEASE 0 CONVERSION YEAR: 7,0 f MFO/MAKE: C he vj etv65 MODEL: iltlet) MILEAGE: CURRENT Not applicable to Towable Recreational Vehicles CONVERSION CO: LEASE Ca SELLING DEALER: SERVICING DEALERS ger g14- c_ Chf Oftti.14m01& AT DELIVERY: 3 3 1) ni 4 n I e v ro k44 c A irro DATE PURCHASED: DATE 24,000 MILES REACHED: ti / 47/7, /el CITY: acrriet.-ly- CITY: 14t) S +Or\ r CITY: CITY: DEALER ADDED OPTIONS: fi WHAT REMEDY ARE YOU SEEKING?: tgl REPURCHASE/REPLACEMENT or Ej REPAIRS, 2 Z c7z- IL S *FEB1flA
2 EXISTING PROBLEMS LOG You MUST complete this section on this form or the form will be returned as incomplete. "See Attached" or equivalent is NOT a substitute for completion. You may make copies of this page to address additional concerns. Description of one problem that CONTINUES TO EXIST: Repair Visits / Pt`t tka. cl4 t9s p i-f-Y (ails) Ix 7/ ) Di) z Date In Date Out Mileage (J,; 1-2_ -7 si Lii 'LA'S 7/) 7/ S 7 Description of one problem that CQ.NTINUES TO EXIST: Repair Visits Date In Date Out Mileage Losof e r \ kt. et, we-c L.Dhille,-+- h Ili weti 5 (;)-"els', ) Os s cyi e...-- cry.srl-c 0 I I C c4f lii) a Ar+ 5+"7( i- '(.-P-4-CC pka I A.,a ist visit '31-1_71,, ooly ), (Di 1 (4) p4 ' "5 -I'l 1 Description of one problem that CONTINUES TO EXIST: Repair Visits i Date In Date Out Mileage TJe s )-, : fla:i Ck+aS -H&J- ); n3. 1 st visit 24-0) it/ 1 i ispy 11-) Lis i_ Gl-t- i. v iv`1,.. ) CP I ta.) csr.1 s-\--r 1,4 k-r--+/--( pt4. 1 i ; kj 0 1,--0--c- it,' i 4.0 i q i
3 EXISTING PROBLEMS LOG You MUST complete this section on this form or the form will be returned as incomplete. "See Attached" or equivalent is NOT a substitute for completion. You may make copies of this page to address additional concerns \L loes; ) sa-nc+ -it is -Nybiri. 710)/7-5 2_,< vis it I/ ;yin g/7,3111. s Li,r)!Ail-visit 11 4.ti / 1, silij 741pvisit LS mt. 1 /1400.3,!....._...
4 EXISTING PROBLEMS LOG You MUST complete this section on this form or the form will be returned as incomplete. "See Attached" or equivalent is NOT a substitute for completion. You may make copies of this page to address additional concerns. 1 i I 116 (31 dvislt visit SW11-1-1mAi le1003 'I st visit,
5 &O YES 111 NO The manufacturer, converter or distributor of the vehicle (NOT THE DEALER) was given written notice of the problem(s), on 9--- / LI IF YOU ANSWERED NO, PLEASE SEND A LETTER TO THE MANUFACTURER, CONVERTER OR DISTRIBUTOR AS SOON AS POSSIBLE (CERTIFIED MAIL/RETURN RECEIPT IS SUGGESTED) AND INCLUDE A COPY OF THE LETTER WITH THIS COMPLAINT FORM., 20 EYES d NO The vehicle has been inspected by a factory representative. If you answered yes, please provide the inspection date, location, personnel involved, and outcome. Use a separate sheet if needed. DATE: LOCATION: BY WHOM: OUTCOME: I UNDERSTAND THAT THE INFORMATION I AM SUBMITTING MAY BE SHARED WITH THE OTHER INTERESTED PARTIES TO MY COMPLAINT IN ORDER TO RESOLVE THIS MATTER. I HEREBY CERTIFY, UNDER PENALTY OF PERJURY, THAT ALL STATEMENTS IN THIS COMPLAINT ARE TRUE AND CORRECT. SIGNATURE OF VEHICLE OWNER/LESSEE DATE: liq The Texas Department of Motor Vehicles maintains the information collected through this form. With few exceptions, you are entitled on request to be informed about the information that we collect about you. Under Section and ot the Government Code, you also are entitled to receive and review this Information Under Section of the Government Code, you are also entitled to have us correct information about you that is incorrect.
6 ALEXIS BLACK Sun Haven Cave Elgin, TX T January 26, 2015 Classic Chevrolet Management Classic Chevrolet Southwest Freeway Sugarland, Texas Dear Classic Chevrolet Management, The Chevy Aveo I purchased from you on December 9th, 2010 has a serious and dangerous fault. The fault is that the vehicle has shut down (completely lost power) multiple times while driving at freeway speeds (causing me and my husband to lose control of the vehicle in dangerous traffic), it does not start half the time (leaving me stranded, and without transportation on countless occasions), and the dashboard indicators have shut down (all lights and gauges failed) while driving (making it impossible to see what speed I am going, among other things). The faults started as soon as I purchased the vehicle. have made every attempt to have the vehicle repaired. The vehicle has been in an out of Chew service departments since purchase, and has been in the service department of Rush Chevrolet in Elgin Texas, where it has remained for the better part of the past six months. They have made numerous repairs, none of which have solved the problems. Before that, the vehicle was repaired multiple times at Munday Chevrolet in Spring Texas for the same faults. They were also unsuccessful. All repairs have been done by Chevy dealers, so you should be able to look up my repair history in your system. Please contact Service Manager John Gibson for further details on the status of the vehicle and it's repair history. I am entitled to reject the car under the Consumer Guarantees Act. This letter is to inform you that I am rejecting the car today. I now require that you refund me the purchase price. Please contact me to arrange this. I will return the car once you have agreed to refund the purchase price. I would appreciate a reply within two working days of you receiving this letter. Sincerely y Alexis Black
7 5trAot.tgairk* ALEXIS BLACK Sun Haven Cove Elgin, TX I January 26, 2015 Don Kerstetter Classic Chevrolet Southwest Freeway Sugarland, Texas Dear Don Kerstetter, The Chevy Aveo I purchased from you on December 9th, 20/0 has a serious and dangerous fault. The fault is that the vehicle has shut down (completely lost power) multiple times while driving at freeway speeds (causing me and my husband to lose control of the vehicle in dangerous traffic), it does not start half the time (leaving me stranded, and without transportation on countless occasions), and the dashboard indicators have shut down (all lights and gauges failed) while driving (making it impossible to see what speed I am going, among other things). The faults started as soon as I purchased the vehicle. I have made every attempt to have the vehicle repaired. The vehicle has been in an out of Chevy service departments since purchase, and has been in the service department of Rush Chevrolet in Elgin Texas, where it has remained for the better part of the past six months. They have made numerous repairs, none of which have solved the problems. Before that, the vehicle was repaired multiple times at Munday Chevrolet in Spring Texas for the same faults. They were also unsuccessful. All repairs have been done by Chevy dealers, so you should be able to look up my repair history in your system. Please contact Service Manager John Gibson for further details on the status of the vehicle and it's repair history. I am entitled to reject the car under the Consumer Guarantees Act. This letter is to inform you that 1 am rejecting the car today. I now require that you refund me the purchase price. Please contact rne to arrange this. I will return the car once you have agreed to refund the purchase price. I would appreciate a reply within two working days of you receiving this letter. Sincerely yours, Alexis Black
8 ALEXIS BLACK Sun Haven Cove Elgin, TX January 26, 2015 Classic Chevrolet Finance Department Classic Chevrolet Southwest Freeway Sugarland, Texas Dear Classic Chevrolet Finance Department, The Chevy Aveo I purchased from you on December 9th, 2010 has a serious and dangerous fault. The fault is that the vehicle has shut down (completely lost power) multiple times while driving at freeway speeds (causing me and my husband to lose control of the vehicle in dangerous traffic), it does not start half the time (leaving me stranded, and without transportation on countless occasions), and the dashboard indicators have shut down (all lights and gauges failed) while driving (making it impossible to see what speed I am going, among other things). The faults started as soon as I purchased the vehicle. I have made every attempt to have the vehicle repaired. The vehicle has been in an out of Chevy service departments since purchase, and has been in the service department of Rush Chevrolet in Elgin Texas, where it has remained for the better part of the past six months. They have made numerous repairs, none of which have solved the problems. Before that, the vehicle was repaired multiple times at Munday Chevrolet in Spring Texas for the same faults. They were also unsuccessful. All repairs have been done by Chevy dealers, so you should be able to look up my repair history in your system. Please contact Service Manager John Gibson for further details on the status of the vehicle and its repair history. I am entitled to reject the car under the Consumer Guarantees Act. This letter is to inform you that I am rejecting the car today.1 now require that you refund me the purchase price. Please contact me to arrange this. I will return the car once you have agreed to refund the purchase price. I would appreciate a reply within two working days of you receiving this letter. Sincere1ly yours, Alexis Black
9 ALEXIS BLACK Sun Hoven Cove Elgin, TX T February 4th, 2015 General Motors Company P.O. Box Detroit, MI Dear General Motors, The Chevy Aveo I purchased from Classic Chevrolet in Sugarland Texas on December 9th, 2010 has a serious and dangerous fault. The fault is that the vehicle has shut down (completely lost power) multiple times while driving at freeway speeds (causing both my husband, and Ito lose control of the vehicle in dangerous traffic on several occasions), it does not start half the time (leaving me stranded, and without transportation on countless occasions), and the dashboard indicators have shut down (all lights and gauges failed) while driving (making it impossible to see what speed I am going, among other things). The faults started as soon as I purchased the vehicle and are ongoing despite numerous repairs. I have made every attempt to have the vehicle repaired. The vehicle has been in an out of Chevy service departments since purchase, and has been in the service department of Rush Chevrolet in Elgin Texas, where it has remained for the better part of the past six months. They have made numerous repairs, none of which have solved the problems. Before that, the vehicle was repaired multiple times at Munday Chevrolet in Spring Texas for the same faults. They were also unsuccessful. All repairs have been done by Chevy dealers, so you should be able to look up my repair history in your system. Please contact Service Manager John Gibson for further details on the status of the vehicle and it's repair history. I am writing to reject the vehicle based on the fact that it is faulty and dangerous. i have already notified Classic Chevrolet, who told me to file a complaint with CM. I am preparing to file a Lemon Law complaint as well, and I am prepared to seek legal recourse if necessary. This letter is to inform you that I am rejecting the car today. I now require that you refund me the purchase price. Please contact me to arrange this. I will return the car once you have agreed to refund the purchase price. I would appreciate a reply within two working days of you receiving this letter. Sincerely yours, Alexis lack
10 ALEXIS BLACK Sun Haven Cove Elgin, TX T February 16,2015 Lemon Law Complaints Department Department of Motor Vehicles PO Box Austin, TX Dear Department of Motor Vehicles, Thank you for reviewing my Lemon Law Complaint. My vehicle has been in the service department at Rush Chevrolet, in Elgin, Texas for over 6 months. This is the most recent in a long series of attempts to repair the faulty vehicle I purchased from Classic Chevrolet in Sugarland Texas on 12/4/2010. I have been experiencing problems with the vehicle since the first week of purchase, and have made every effort to have the vehicle repaired, but the problems persist. I was unable to include the most recent repair order for the vehicle because it is still in the shop. For information regarding the current condition of the vehicle, please contact service manager John Gibson at Rush Chevrolet in Elgin TX. The number there is Included in this envelope you will find: Lemon Law Complaint Form Check for S35 filing fee, payable to Texas Department of Motor Vehicles Copies of letters to General Motors, Classic Chevrolet Management, Don Kersetter (owner Classic Chevrolet), and Classic Chevrolet Finance Dept. stating that the vehicle has serious, dangerous, irreparable faults and that I reject the vehicle and demand a full refund. Sales Contract Odometer Disclosure Statement Vehicle Report Copies of most service invoices If you require further information, please don't hesitate to contact me. Thank you for your consideration. Since ly yours, Alexis Black
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