C. STEVEN MOSKOS, P.A.
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New vehicle contact form
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please only use this form if you purchased a new vehicle.
*PLEASE NOTE THERE IS A CHARGE FOR THE INITIAL CONSULTATION.*
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Indicates required field
Name
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First
Last
Email
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Phone Number
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Cash price of the vehicle
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Year of Vehicle
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Date vehicle was purchased
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Make & Model of Vehicle
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Dealership where vehicle was purchased
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Street address and city and state where dealership is located
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What is the full purchase price including all taxes, extended warranties, and other items included in the purchase of the vehicle?
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Amount of down payment – include all cash put down and trade-in
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Is the car currently under a manufacturer's warranty?
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Was the vehicle under a manufacturer's warranty when the main issue occurred?
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Who holds the extended warranty, if applicable?
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# of Times vehicle was in shop for primary problem
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Current mileage
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How many days has the vehicle been out of service?
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Mileage when primary problem first occurred
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Is the primary problem still happening?
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Has the vehicle been in an accident while you've owned it?
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Has the vehicle been modified? If so, how?
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Did the dealership lie to you?
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If so, what were the lies?
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How much money do you think you have lost or it will take to fix the issues?
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Please state specifically how you would like this problem resolved.
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Please list all unresolved problems with the vehicle.
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Please state the name of the party who referred you to this office.
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Submit