Your Name: 

Address 

Phone 

Car (Make, Model, Year) 

Where Purchased 
Dealer Address 
Phone 
Manager's name 
Salesperson's name 
Owner's name 

Price Paid  Financed:  cash  lease dealer 
 finance  other 

Payments month/week:  Interest rate:

Were you given a warrantee?  in writing?  verbally? 

Has it been honored? 

Have you complained (please see our Consumer Resource list for 
further information) : 

 The dealer  OR Department of Justice-- Consumer Hotline

 Better Business Bureau  Fed. Trade Commission

 The manufacturer  The local trade assoc.

Do you still have the car? 

If yes, it is drivable?  Are you driving it?  
Is it safe? 

When buying the car, did you ask them:

Is there a prepayment penalty?  yes  no

How much value the vehicle would lose when it leaves the dealer?  yes  no

To explain conditions on the warrantee?  yes  no

Did you feel misled?  yes  no Please explain 

For all consumers, tell us what happened.