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Kimmel & Silverman Lemon Data Sheet

If you wish for us to review your case, please fill out the form shown below and submit. Our attorneys will then contact you.
(Please be sure to fill in your telephone numbers)

Personal Information:
First Name:
Last Name:
E-Mail:
Mailing Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:

Computer Details:
Manufacture:
Model:
Serial Number:
Purchase Date:
State of Purchase:

Relief Sought:
Computer Replacement
Computer Refund
Computer Repair

In the spaces provided, please list the SYMPTOMS that you have experienced, the number of repairs for each (whether documented or not), and the approximate date(s) when the computer was inspected and/or repaired for each symptom.

Symptoms
 Number of Trips to Dealer Date(s) in Repair Shop
1.   1. 1.
2. 2. 2.
3. 3. 3.
4. 4. 4.
5. 5. 5.
6. 6. 6.

 

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For more information, call: 1-800-LEMON-LAW (1-800-536-6652)

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The Lemon Law Firm of Kimmel & Silverman, P.C
serving consumers across Pennsylvania, New Jersey & Delaware with offices in
Ambler, PA; Pittsburgh, PA; Cherry Hill, NJ; and Wilmington, DE

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