Moran et al. v. FCA US LLC

1) Claimant Identification

2) Arbitration

1. Will you be represented in arbitration by an attorney with respect to your Claim for Repurchase or Breach of Express Warranty?
   
   Yes

   No
2. Preferred Method of Contact
   
   Select Choice Email Mail Phone
3. VIN of your Class Vehicle
   
4. Date on which you purchased or leased your Class Vehicle
   
5. Do you still own or lease the vehicle identified?
   
   Yes

   No
6. Remedy you intend to seek in arbitration
   Repurchase of my vehicle because of stalling problems
   Breach of FCA US LLC’s New Vehicle Limited Warranty or extension thereof
   • Repair of my vehicle’s stalling issue


7. Number of attempts you have made to have your stalling issues repaired by FCA US LLC or its authorized dealer(s)
   
   Select Choice 1-3 4+
8. Are you still having stalling problems with the vehicle?
   
   Yes

   No
9. Additional Comments (Optional)