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Call: (713) 942-0808 |  6300 West Loop South Suite 280 Bellaire, Texas 77401
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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     Model  
Dealer Name
Dealer Address
City
  State
Date Purchased     Year  
Purchase Price     Mileage at purchase  
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: