Repossession Intake Form

If you have any questions, The Lemon Law Center invites you to fill out the form below and add your comments. Thank You!

Name
Street Address
City
State
Zip Code
Telephone/Work
Telephone/Home
Telephone/Cell
Email Address
Type of Vehicle	New Used
Name of Lender
Has the vehicle been repossessed yet?	Select YES NO
Date of Repossession
Location of vehicle when repossessed
Name of Selling Dealer
Did the Dealer find the Lender for you?	Select YES NO
Have you received a letter from the Lender?	Select YES NO
Has your vehicle been sold?	Select YES NO
Have you been sued by the Lender?	Select YES NO
Comments:
Please add some comments here.

---

The Law Office of Michael E. Lindsey
Tel: (858) 270-7000 Fax: (858) 270-7710