(Please print clearly in ink)
Pursuant to the Iowa Lemon Law, notice is given to
the manufacturer as follows: (check all that apply)
____ The vehicle has been out of service at least
20
cumulative days to repair one or more malfunctions
or
conditions that cause the vehicle not to conform
to the warranty.
____ Three or more repair attempts have been made
to repair the same defect or condition.
____ The vehicle has been in the shop one time by
reason of a defect likely to cause death or substantial bodily injury.
Description of continuing defect(s) or condition(s):
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
(Note To The Manufacturer: this may not be a complete
description; the manufacturer should ascertain all appropriate
information).
I am requesting that you make a final attempt to correct
the continuing substantial defect(s) or condition(s).
Veh. Make _________________Model _____________ Year
________
Vehicle Identification Number _________________________________
Name and City/State of selling dealer of leasing co.
__________
________________________________________________________________
Date of Delivery _________ Odometer reading at delivery
_______
Today's date _____________ Current odometer reading
_________
Name and City/State of authorized service agent(s)
attempting
previous repairs: _____________________________________________
________________________________________________________________
________________________________________________________________
Consumer _____________________ Home phone (_____)______________
Address _____________________ Work phone (_____)______________
_____________________ Signature ______________________
