Legal Forms > Consumer > Lemon Law
Repurchase Or Replacement Request (New Vehicles Purchased On Or Before 12-31-08) (Georgia) B - Legal Forms
| Repurchase Or Replacement Request (New Vehicles Purchased On Or Before 12-31-08) (Georgia) Form. This is a Legal Forms form and can be used in Lemon Law Consumer . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
REPLACEMENT OR REPURCHASE REQUEST As detailed below, this constitutes my request as a consumer for a repurchase or a replacement vehicle, pursuant to Georgia's Motor Vehicle Warranty Rights Act, O.C.G.A. Section 10-1-784(a)(1). Vehicle make _____________________________ Model _______________________ Year ____________ Vehicle identification number (VIN) ___________________________________________________________ Name/address of the selling or leasing dealer ____________________________________________________ ________________________________________________________________________________________ Date of vehicle delivery __________________________ Current odometer reading ____________________ Date of request for final repair attempt _________________________________________________________ Note to consumer: If the manufacturer designated a repair facility within seven (7) days from the receipt of your final repair attempt request, please list the following: Date of final repair _________________________________________________________________________ Name of the facility where the final repair attempt took place _______________________________________ _________________________________________________________________________________________ Does/do the defect/s or condition/s continue to exist? ________________ Yes ________________ No ********************************************************************************** I am requesting that you replace or repurchase (circle one) the vehicle described above within thirty (30) days from the receipt of this notice. My contact information is: Consumer name ________________________________________ Home phone _______________________ Address _______________________________________________ Work phone _______________________ Consumer signature ______________________________________ Today's date _ ______________________ Instructions to consumer: Remember to make a copy of this form for your records and send the original by certified mail, return receipt requested, to the manufacturer at the address provided in your owner's manual. If your vehicle is a motor home, notices must be sent to all known manufacturers. B American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
