Vehicle Problem Assessment Sheet If you would like us to see whether we can help with your vehicle complaint, please fill out the following "Vehicle Problem Assessment Sheet." When you have completed the form please press the submit button and someone will contact you by email. DO NOT SUBMIT AN INQUIRY UNLESS YOUR TRANSACTION ORIGINATED IN TEXAS.   IF YOUR TRANSACTION OCCURRED OUTSIDE OF TEXAS NO RESPONSE WILL BE GIVEN.  IF YOUR TRANSACTION OCCURRED IN TEXAS BUT OUTSIDE OF THE HOUSTON AREA YOU MAY BE ASKED FOR ADDITIONAL INFORMATION.  IF YOUR TRANSACTION OCCURRED IN THE HOUSTON TEXAS AREA I WILL ATTEMPT TO RESPOND. Thank You! Vehicle Information (Provide as much as possible) Year     Make   Select Make Acura Audi BMW Buick Cadillac Chevrolet Chrysler Daewoo Dodge Eagle Ford Hyundai Infiniti Jaguar Kia Lexus Lincoln Mazda Mercedes Mercury Mitsubishi Nissan Oldsmobile Plymouth Pontiac Porsche Saab Saturn Subaru Suzuki Toyota Volkswagon Volvo   Model   Dealer Name Dealer Address City   State Date Purchased   Select Month January February March April May June July August September October November December   Year   Purchase Price     Mileage at purchase   <1000 <30000 <50000 >50000 This vehicle was purchased/leased:     new     used     demo Current Mileage:   Contact Information Your name E-mail Address Address City   State   Zip Home Phone   Work Phone Pager   Fax Problem Information Please check all that apply to your situation.   Bad Car     Bad Dealer Non-Disclosure of Prior Collision   Paid price Higher than Advertised Non-Disclosure of Prior Flood   Problem with Extended Service Contract Non-Disclosure of Prior Salvage/Branded Title   Problem with Credit Life/Disability Insurance Non-Disclosure of Prior Lemon   No Title transferred Motor Home   Spot Delivery Are you from Texas or did your consumer transaction take place in Texas? Yes   No Dollar range of problem Less than $1000   $1000-$5000   $5000+ If you would like to tell us a little more about your problem, please explain below: