Demand For Arbitration (Hawaii) | Pdf Fpdf Doc Docx | Legal Forms

Demand For Arbitration (Hawaii)

Demand For Arbitration (Hawaii) | Pdf Fpdf Doc Docx | Legal Forms

Demand For Arbitration (Hawaii) Form

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This is a Legal Forms form that can be used for Lemon Law within Consumer.

DEMAND FOR ARBITRATION TO: NAME (Manufacturer's Name) ADDRESS CITY AND STATE ZIP CODE DEALER or LESSOR NAME REGISTERED OWNER RE: VEHICLE MAKE ( ) Manual Transmission or MODEL ( ) Automatic Transmission YEAR ORIGINAL PURCHASE DATE PURCHASE PRICE VEHICLE ID NUMBER ODOMETER READING at time of this application In accordance with Chapter 481I, Hawaii Revised Statutes, I (We), the undersigned party(ies), hereby demand arbitration. I hereby certify the following: I. (Check only one) A. B. () () This vehicle is used primarily for personal, family and/or household use. This vehicle is individually registered and used for business purposes as well as for personal, family or household purposes. This vehicle is owned or leased by a sole proprietorship, corporation or partnership which has purchased or leased no more than one vehicle per year, used for household, individual, or personal use in addition to business use. C. () II. III. () () The gross weight of this vehicle does not exceed 10,000 pounds, gross vehicle weight rating. I have notified the Manufacturer in writing about the alleged defect(s) and have given the Manufacturer a reasonable opportunity to correct the defect(s). (Attach three [3] copies of letter written to the Manufacturer and return receipt). My vehicle's factory (manufacturer's) warranty expires on [3] copies of warranty). (Attach three IV. () American LegalNet, Inc. V. I hereby certify that during the lemon law rights period, the following condition(s) were met (check all that apply and provide proof at the hearing): A. () My vehicle's defect was subject to examination or repair at least once, but continues to be a defect which is likely to cause death or serious bodily injury if the vehicle is driven. PROBLEM:__________________________ REPAIR DATE(S): ___________________________ B. () My vehicle's defect was subject to examination or repair three or more times for the same problem by the manufacturer or its authorized agents, and the problem still exists. (Attach extra sheets if necessary to show all the problems and repair dates.) PROBLEM DATE 1 DATE 2 DATE 3 C. () My vehicle has been out of service by reason of repair for a cumulative total of thirty or more business days during the Lemon Law Rights period. (Attach extra sheets if necessary to show all the repair dates.) DAYS OUT OF SERVICE FOR DATE REPAIR REPORTED / / / / PROBLEM 1. 2. 3. 4. VI. ODOMETER READING / / / / WORK ORDER # Which problem(s) mentioned above, continues to exist? (Do not leave this section blank) VII. RELIEF SOUGHT ( ) replacement vehicle ( ) refund $ $ VIII. INCIDENTAL EXPENSES (e.g. towing, rental car, etc.) I hereby request arbitration of my case in person with the arbitrator, any witnesses, and relevant documents by the State Certified Arbitration Program. I certify that all statements made in connection with this demand for arbitration are true and correct to the best of my knowledge. I understand that this document and its attachments are records of the DCCA. Signed: (may be signed by representative) Name(s) of Claimant Name of Attorney or other representative Address Address Date: Telephone (home) Telephone (business) Cell No. __________________________________ Fax No. ___________________________________ Email _____________________________________ Telephone Fax No. American LegalNet, Inc.