Elementor #1780 - Consumer Legal Remedies, APC

DPS6 SETTLEMENT SURVEY

PLEASE ENTER YOUR SURVEY CODE # FROM THE EMAIL SENT TO YOU:

Name:

Email:

Phone Number:

Address 1:

City:

Zip:

State:

Vehicle:

Fiesta Focus

Do you still own the Vehicle?

Yes No

Was your Vehicle purchased at a certified Ford Dealership?

Yes No

What was the name of the Dealership where you purchased your Vehicle? (If you purchased from a 3rd Party Dealership or Private Sale, or was a Gift, etc., please state so.)

Please provide the name(s) of all Dealerships that serviced your Vehicle. (If NONE, type "None.)

Before purchasing your Vehicle, were you ever informed by the Dealership salesperson that the DPS6 PowerShift transmission would feel very similar to a “standard” or “manual” transmission?

Yes No

Before purchasing your Vehicle, were you ever informed by the Dealership salesperson that the DPS6 PowerShift transmission was a really a sophisticated “standard” or “manual” transmission?

Yes No

Before purchasing your Vehicle, were you ever informed by the Dealership salesperson that owners of similar Ford Vehicles have/had experienced problems with the function or operation of the transmission that Ford could not fix or permanently repair?

Yes No

Would you (or any co-owner) have purchased the Vehicle if you had known about the transmission problem that Ford apparently cannot fix or permanently repair?

Yes No

How long after purchasing your Vehicle did you first begin experiencing any problems with the function or operation of the transmission?

Did you ever request an inspection or service for the transmission, but were denied or refused service? If so, please provide as much detail as possible: When? Whom did you speak with at the servicing Dealership? What was said?

Which of the following Ford Dealership employees have responded to your transmission complaints by using any of the explanations listed immediately above? Please check any that apply:

Name of the Ford Dealership employee(s) listed above, if known:

Name of any owner or co-owner present when the statements above were made:

Did you or any co-owner rely on any of these explanations as the reason for not seeking more service or repairs from the Dealership for your transmission complaints?

Yes No

Name(s) of co-owners relying on the statement(s) above:

Did you ever receive from the Dealership a written overview/hand-out, notice or summary, describing the problems with your transmission as part of a normally operating transmission?

Yes No

Did you or any co-owner rely on this overview/hand-out in not seeking more repairs?

Were you ever informed that your Vehicle qualified for a repair, but due to parts or tool shortages the repair could not be performed?

Yes No

If yes, did this delay in providing parts or tools prevent you or any co-owner of your Vehicle from receiving additional repairs?

Yes No

Was there anything else that the Dealership informed you about your Vehicle, or did in response to a transmission repair attempt that you relied upon in deciding not to seek additional repairs? Please explain:

Were you ever charged a fee by the servicing Dealership to have the Vehicle transmission problem diagnosed? If so, when and how much?

Were you ever unable to proceed with a transmission repair due to a required fee (for a Vehicle diagnostic Service)?

Yes No

Did any other event, conversation, message or circumstance occur, other than as described above, influence your decision or ability to receive or pursue more repairs? If so, please explain:

Has any Dealership representative ever told you that the transmission is defective or that you "should call Ford and request a buyback”?

Yes No

If you answered “Yes” above, please provide the name of the Ford Dealership and employee(s), if known:

If you answered “Yes” above, please provide the name of owner or co-owner present when the statements above were made:

If you answered “Yes” above, please explain in detail what was said to you: