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Potential Case Submission Form (Auto Fraud)

(Texas residents only)

No attorney’s fees, court costs, or expenses unless you recover.

Please provide the following information, click the "Submit Form" button at the bottom, and our law firm will contact you regarding your potential case. The Law Offices of Dean Malone, P.C. and its attorneys do not hereby agree to take the submitted case, but rather will only do so through a written agreement with a prospective client.

What is the name, address, and telephone number of the dealer where you purchased your vehicle?

What year, make, and model vehicle did you purchase?

What date did you purchase your vehicle?

Did you purchase a new or used vehicle?

Did you obtain financing for the vehicle through the dealer?

Did you trade in a vehicle?

If you traded in a vehicle, did you owe more for it than it was worth?

Please provide the names and job titles of all dealer employees with whom you spoke.

Please state in detail (including names) what the dealer told you about obtaining financing for the vehicle.

What has the dealer done that you consider to be improper or harassing, or that you believe might violate the law?

Please provide the following contact information:

First Name
Last Name
Middle Initial
Street Address
Address (cont.)
City
State	Texas
Zip Code
Work Phone
Home Phone
FAX
E-mail
Confirm E-mail

Are you currently involved in a bankruptcy proceeding?

Yes No

What is your county of residence?

Is there any additional information which you would like to provide?

Security test. Please identify the pictures:*