Form CFB008 "New York Used Car Lemon Law Arbitration Program Request for Arbitration Form" - New York

What Is Form CFB008?

This is a legal form that was released by the New York State Department of Law - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2020;
  • The latest edition provided by the New York State Department of Law;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFB008 by clicking the link below or browse more documents and templates provided by the New York State Department of Law.

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Download Form CFB008 "New York Used Car Lemon Law Arbitration Program Request for Arbitration Form" - New York

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INSTRUCTIONS FOR COMPLETING
THE USED CAR LEMON LAW
REQUEST FOR ARBITRATION FORM
To participate in the New York State Used Car Lemon Law Arbitration Program, you must
complete this form. Be as accurate and complete as possible. You may send this form
electronically (to expedite the handling of your request) or by regular mail. You may attach
copies of all relevant documents (including your purchase or lease agreement, all service or work
orders relating to the problem for which you seek this arbitration, and any correspondence
between you and the manufacturer or its authorized dealer relating to such problem). DO NOT
SEND ORIGINAL DOCUMENTS. DO NOT TAPE, STAPLE, OR GLUE DOCUMENTS
TOGETHER IF YOU ARE SUBMITTING THEM BY REGULAR MAIL. Sign and return
the completed form to:
Email: NYAG.LemonLaw@ag.ny.gov
(To expedite the handling of your request please email this form to us.)
You may also mail it to:
New York State Attorney General's Office
28 Liberty Street, 15 th Floor
New York, NY 10005
Attention: LEMON LAW ARBITRATION UNIT
The Attorney General's Office will review your form and advise you whether your claim is accepted
into the arbitration program. If the form is accepted, you will be notified by the Attorney General's
Office which will then forward your form and documents to the New York State Dispute
Resolution Association (NYSDRA), the Program Administrator. NYSDRA will then ask you to
send it the required $150 filing fee. Upon receipt of the filing fee, NYSDRA will begin
processing your claim. If your form is rejected by the Attorney General’s Office, it will be
returned to you with a statement indicating the reason for its rejection.
DO NOT SEND A FILING FEE UNTIL NYSDRA ASKS YOU TO DO SO.
Please remember to sign and date the form. Failure to complete any question may result
in a rejection of the form.
_________________________________________________________________________
NOTICE: THE ARBITRATOR'S DECISION UNDER THIS PROGRAM IS BINDING ON BOTH
PARTIES, SUBJECT TO A LIMITED RIGHT OF APPEAL TO COURT BY EITHER PARTY.
YOU MAY WISH TO CONSULT AN ATTORNEY BEFORE PARTICIPATING IN THIS
PROGRAM. PLEASE READ "NEW YORK'S USED CAR LEMON LAW: A GUIDE FOR
CONSUMERS" CAREFULLY BEFORE COMPLETING THIS FORM.
_________________________________________________________________________
INSTRUCTIONS FOR COMPLETING
THE USED CAR LEMON LAW
REQUEST FOR ARBITRATION FORM
To participate in the New York State Used Car Lemon Law Arbitration Program, you must
complete this form. Be as accurate and complete as possible. You may send this form
electronically (to expedite the handling of your request) or by regular mail. You may attach
copies of all relevant documents (including your purchase or lease agreement, all service or work
orders relating to the problem for which you seek this arbitration, and any correspondence
between you and the manufacturer or its authorized dealer relating to such problem). DO NOT
SEND ORIGINAL DOCUMENTS. DO NOT TAPE, STAPLE, OR GLUE DOCUMENTS
TOGETHER IF YOU ARE SUBMITTING THEM BY REGULAR MAIL. Sign and return
the completed form to:
Email: NYAG.LemonLaw@ag.ny.gov
(To expedite the handling of your request please email this form to us.)
You may also mail it to:
New York State Attorney General's Office
28 Liberty Street, 15 th Floor
New York, NY 10005
Attention: LEMON LAW ARBITRATION UNIT
The Attorney General's Office will review your form and advise you whether your claim is accepted
into the arbitration program. If the form is accepted, you will be notified by the Attorney General's
Office which will then forward your form and documents to the New York State Dispute
Resolution Association (NYSDRA), the Program Administrator. NYSDRA will then ask you to
send it the required $150 filing fee. Upon receipt of the filing fee, NYSDRA will begin
processing your claim. If your form is rejected by the Attorney General’s Office, it will be
returned to you with a statement indicating the reason for its rejection.
DO NOT SEND A FILING FEE UNTIL NYSDRA ASKS YOU TO DO SO.
Please remember to sign and date the form. Failure to complete any question may result
in a rejection of the form.
_________________________________________________________________________
NOTICE: THE ARBITRATOR'S DECISION UNDER THIS PROGRAM IS BINDING ON BOTH
PARTIES, SUBJECT TO A LIMITED RIGHT OF APPEAL TO COURT BY EITHER PARTY.
YOU MAY WISH TO CONSULT AN ATTORNEY BEFORE PARTICIPATING IN THIS
PROGRAM. PLEASE READ "NEW YORK'S USED CAR LEMON LAW: A GUIDE FOR
CONSUMERS" CAREFULLY BEFORE COMPLETING THIS FORM.
_________________________________________________________________________
Office Use Only:
Case No.
__________________
Referred To NYSDRA ___________
Filing Date
__________________
NEW YORK STATE ATTORNEY GENERAL=S OFFICE
LETITIA JAMES, ATTORNEY GENERAL
NEW YORK USED CAR LEMON LAW ARBITRATION PROGRAM
REQUEST FOR ARBITRATION FORM
CONSUMER INFORMATION
1.
Name:
___________________________________________________________________
Address:
___________________________________________________________________
City:
____________________________
State:_______ Zip:___________________
Phone: Home (______)_____-________________
Work:(______)_____-__________________
E-mail address: ___________________________________________________________________
[ ]
I prefer to send/receive communications by e-mail rather than by regular mail.
DEALER INFORMATION
2.
Name: _________________________________________________________________________
Address:
___________________________________________________________________
City:
_________________________ State: _____________ Zip: ___________________
VEHICLE INFORMATION (Attach Copy of Your Bill of Sale or Lease)
3.
Manufacturer: ___________________________________________________________________
(GM, Ford, Chrysler, Toyota, Winnebago, etc.)
4.
Year: ____________ Make: ___________________ Model: _____________________________
(ex. Chevrolet, Dodge)
(ex. Cavalier, Caravan)
5.
Vehicle Identification Number (VIN):_________________________________________________
6.
Date of delivery: _____________________ Mileage at delivery: _________________________
7.
Did you purchase or lease your vehicle in New York? ....................
Yes[ ] No[ ]
[ ] I purchased my vehicle.
[ ]
I leased my vehicle.
8.
Purchase Price: $_______________________
1
9.
Is your vehicle primarily used for personal, family or
household purposes?
.......................................................................
Yes[ ] No[ ]
10.
Do you still own (or lease) your vehicle? ........................................
Yes[ ] No[ ]
WARRANTY INFORMATION
11.
Which warranty applies to you (choose only one of the following)?
(a) 90 days or 4,000 miles from the date of delivery,
whichever came first, if the vehicle was purchased or
leased with between 18,000 and 36,000 miles?.................
Yes[ ] No[ ]
or
(b) 60 days or 3,000 miles from the date of delivery,
whichever came first, if the vehicle was purchased or
leased with between 36,001 and 80,000 miles?.................
Yes[ ] No[ ]
or
(c) 30 days or 1,000 miles from the date of delivery,
whichever came first, if the vehicle was purchased or
leased with between 80,001 and 100,000 miles?...............
Yes[ ] No[ ]
BANK OR FINANCING INSTITUTION (if financed):
12.
Name:
_______________________________________________________________
Address:
_______________________________________________________________
City:
_______________________ State:____________ Zip:___________________
LEASING COMPANY (if leased):
13.
Name:
_______________________________________________________________
Address:
_______________________________________________________________
City:
_______________________ State:_____________ Zip:_________________
Lease Acct #: _______________________________________________________________
VEHICLE'S PROBLEM(S)
14.
Briefly describe the problem(s) for which you seek relief:
___________________________________________________________________________
___________________________________________________________________________
2
15.
On what date and at what mileage did you first report this problem(s)
to the dealer or the manufacturer?..... Date: ____________ Mileage: ________________
16.
Does the problem(s) substantially impair the value of the vehicle to you?
………………………………………………………………………..
Yes [ ] No [ ]
BASIS FOR RELIEF SOUGHT:
You must complete at least one of the following two questions (17
or 18).
17.
Unsuccessful Repair Attempts
A.
How many repair attempts for the same problem were made by the selling dealer, or authorized
by the dealer, within the warranty period that applies to your vehicle (see question #11)
B.
Give the date, mileage, and work order number for each of the repair attempts by the dealer for
the same problem.
Problem 1 (Specify) _____________________________________________
Date
Mileage
Work Order #
(1)
______________
_______________
____________________
(2)
______________
_______________
____________________
(3)
______________
_______________
____________________
Problem 2 (Specify) _____________________________________________
Date
Mileage
Work Order #
(1)
______________
_______________
____________________
(2)
______________
_______________
____________________
(3)
______________
_______________
____________________
C.
Do you have copies of all relevant work orders?...................
Yes [ ] No [ ]
(If yes, attach copies of them. Otherwise, once accepted into the Program, you may request
copies from the dealer, with the arbitrator's approval, by writing to the Administrator
pursuant to Regulation '300.9.)
D.
Did the problem continue to exist at the end of the third repair attempt?
………………………………………………………………. Yes [ ] No [ ]
3
18.
Days in Shop for Repairs
A.
How many days was the vehicle out of service due to repairs within the warranty period that
applies to your vehicle (see question #11)?
_______________ days.
B.
List the dates, mileage, and repair order numbers for those repairs:
From:_______ To:_______ Days out:_____ Mileage:__________ Work Order #____________
From:_______ To:_______ Days out:_____ Mileage:__________ Work Order #____________
From:_______ To:_______ Days out:_____ Mileage:__________ Work Order #____________
C.
Do you have copies of all relevant work orders?...............
Yes [ ] No [ ]
(If yes, attach copies of them. Otherwise, once accepted into the Program, you may request
copies from the manufacturer, with the arbitrator's approval, by writing to the Administrator
pursuant to Regulation '300.9.)
HEARING LOCATION
19.
Please indicate where you want the arbitration hearing to be held:
[ ] Albany
[ ] Hempstead
[ ] Oneida
[ ] Amsterdam
[ ] Highland
[ ] Oneonta
[ ] Auburn
[ ] Hudson
[ ] Oswego
[ ] Batavia
[ ] Ilion
[ ] Penn Yan
[ ] Binghamton
[ ] Ithaca
[ ] Plattsburgh
[ ] Bronx
[ ] Jamaica
[ ] Poughkeepsie
[ ] Brooklyn
[ ] Jamestown
[ ] Rochester
[ ] Buffalo
[ ] Johnstown
[ ] Saratoga Springs
[ ] Canandaigua
[ ] Lake Placid
[ ] Schenectady
[ ] Carmel
[ ] Lower Manhattan
[ ] Smithtown
[ ] Catskill
[ ] Lowville
[ ] Speculator
[ ] Cobleskill
[ ] Lyons
[ ] Staten Island
[ ] Corning
[ ] Malone
[ ] Syracuse
[ ] Cortland
[ ] Monticello
[ ] Troy
[ ] Delhi
[ ] Montour Falls
[ ] Upper Manhattan
[ ] Elmira
[ ] New City
[ ] Utica
[ ] Fort Edward
[ ] Niagara Falls
[ ] Waterloo
[ ] Geneseo
[ ] Norwich
[ ] Watertown
[ ] Glens Falls
[ ] Ogdensburg
[ ]Yonkers
[ ] Goshen
[ ] Olean
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