Prospective Client Questionnaire/Application

If you would like our assistance in evaluating your potential claim against an auto dealer, please provide the information requested below.  Once completed, you will be directed to a client questionnaire page.  Print and complete the questionnaire, and return the completed questionnaire to our office with copies of your purchase documents.

Please provide the following information: (* required fields)

First Name *
Last Name *
Street Address *
Address (cont.)
City *
State/Province *
Zip/Postal Code *
Country
Work Phone
Home Phone *
FAX
E-mail *
James H. Owen   
Copyright © 2004 Law Office of James H. Owen. All rights reserved.
Revised: December 28, 2004