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The Law Office of Anthony T. Ballato
5476 Merrick Rd
Massapequa, New York 11758
Mon-Fri 9am-5pm Telephone: (516) 541-9080

Free Case Evaluation Form

Please provide as much information as possible keeping in mind that mileage and dates of service are important in assessing your claim. For immediate assistance, please call our New York and Long Island Lemon Law Attorney office at 516-541-9080.

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Contact Information

Owner(s) Name(s):*  
Email:*  
Phone:*  
Address:  
State:*  
 
City:  
Zip:  
Best Time to Contact:  
How You Found Us:  
Do You Still Possess the Car:  
 

Dealer Information

Name:  
Address:  
City:  
State:  
Zip:  
Phone:  
 

Vehicle Information

Purchased:  
Terms:  
Vehicle Delivery Date:*  
Year:*  
Make: *  
Model: *  
Purchase Price:   $
Mileage at Purchase:  
Current Mileage:  
Current Warranty:  
Dealer Options &
After Market Equipment:
 
 

Problem Details

Rental Fees:   $
Trade Ins:   $
Allowance:   $
Rebate:   $
Car Problems &
Work Performed:
 
Problems Caused by
After Market Equipment:
 
First Date Problem
was Reported to Dealer:
 
Mileage at that Time:  
Number of Repair Attempts
for Same Problem:
 
Total Days Out of
Service or In Repair Shops:
 
Problem Resolved:  
Vehicle Use:  
Repair Detail Information:   Please provide the following information about as many repairs as possible in Chronological Order, and for each repair SEPARATELY specify:

  • Date In the Repair Shop OR Date of Break Down.
  • Date Out of Repair Shop OR When Vehicle was Ready for Pick Up.
  • Mileage at time of breakdown OR When In the Repair Shop.
  • Problems or defects complained of to the Dealer.
  • Repairs performed, if any, and any parts ordered.
  • State all charges incurred for towing, rentals, repairs, etc.
  • Describe any unusual circumstances or after-market equipment or modifications attributed to the vehicle.

PLEASE NOTE THAT PROSPECTIVE CLIENTS MUST PROVIDE ALL THESE FACTS THAT ARE NECESSARY TO ASSESS YOUR POSSIBLE CLAIMS, AND THAT THE EXACT DATES IN AND OUT OF THE REPAIR SHOP AND ACTUAL MILEAGE AT EACH REPAIR ARE IMPORTANT, ESPECIALLY IN USED CAR CASES WHERE THE LEMON LAW LIMITS ARE SHORT. SO PLEASE DO NOT OMIT ANY DETAILS NOR GUESS AT THE DATES OR MILEAGE AS THAT CAN WELL CHANGE THE OPINION OR OUTCOME OF YOUR POSSIBLE CLAIMS.

PLEASE FURTHER NOTE THAT YOU MAY MAKE LEGIBLE AND COMPLETE ORGANIZED COPIES OF ALL YOUR PURCHASE OR LEASE DOCUMENTS, REGISTRATION, TITLE, FINANCE AND WARRANTY PAPERS, CORRESPONDENCE OR EMAILS AND ALL REPAIR ORDERS (DO NOT OMIT ANY AS THAT CAN CHANGE THE OPINION OF YOUR POSSIBLE CLAIMS AND REMEDIES) AND MAIL (PREFERABLY VIA FedEx) TO ANTHONY T. BALLATO, ESQ. AT 5476 MERRICK ROAD, MASSAPEQUA, NY 11758. UNLESS AUTHORIZED IN ADVANCE BY THE ATTORNEY, THIS OFFICE CANNOT ACCEPT SUCH DOCUMENTS TO BE EMAILED SO AS TO AVOID ANY CORRUPTED OR ILLEGIBLE DOCUMENTS OR COMPUTER VIRUSES. THANK YOU.

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STATE OF NEW YORK
OFFICE OF THE ATTORNEY GENERAL

Lemon Law Arbitration Unit
120 Broadway
New York, NY 10271
212-416-8300
212-416-8314

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FREE Case Evaluation

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