consumer complaint form with checklist_september 10 2014

Suite 208 - 5455 152nd Street Surrey, British Columbia V3S 5A5

Telephone Toll Free Facsimile

604.575.7255 1.877.294.9889 604.574.5883

Email [email protected] Web www.vehiclesalesauthority.com

Version 4, September 10, 2014

VSA Consumer Complaint Form Checklist

Completing all applicable fields of the Consumer Complaint Form will ensure that the VSA receives sufficient information to fully address your concern. Incomplete applications may cause process delays.

Section 1. Who is filing the complaint?

I completed applicable parts of Section 1:

Part A: My contact information;

Part B: If someone helped me complete this form, my helper’s contact information;

Part C: ONLY for legal representatives acting on behalf of the complainants.

Section 2. Who is the complaint against?

I provided contact information of the dealership and who I dealt with.

Section 3. Vehicle and transaction

I provided vehicle information, including VIN and/or vehicle registration number.

If my complaint involves an RV, I provided both the chassis VIN (noted on the registration) and

the coach VIN.

I provided transaction information.

Section 4. Vehicle’s use/intended use

I provided the information about the use/intended use of the vehicle that is the subject of my

complaint.

Section 5. Details of complaint

I provided a detailed statement of my complaint.

Helpful tip: When preparing your statement, consider answering the following questions about

the circumstances of your dispute: Who? When? Where? What? Why?

Section 6. Required and supporting documents

I attached all relevant supporting documentation including:

Legible copies of front and reverse sides of any sales / lease / consignment contracts,

contracts with banks, etc.;

Copies of vehicle registration and insurance documentation;

Copies of any documentation related to the transaction, including worksheets, receipts, etc.

Section 7. Dispute resolution

I explained how I want to have my complaint resolved.

I explained what I have done to have my complaint resolved.

Section 8. Additional information

I provided additional information as required by the VSA.

Section 9. Terms of service

I read and understood the Terms of service.

Section 10. Survey consent

I provided my consent or dissent to participate in a survey.

Section 11. Acknowledgments and signature

I read and understood the Acknowledgments.

I signed and dated my complaint form.

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Motor Vehicle Sales Authority of BC Consumer Complaint Form

There are three steps to file a complaint against a licensed BC motor dealer: Step 1 Fill out the Consumer Complaint Form, print a copy and sign it. Step 2

a) A copy of your current Vehicle Registration Form (if applicable); b) A copy of sale, lease or consignment agreement (if applicable); c) For a deposit complaint, proof of payment of the deposit, a copy of the deposit agreement or receipt.

Step 3 Send your Consumer Complaint Form with attachments to the Motor Vehicle Sales Authority of BC:

By e-mail to: [email protected], or

By mail to: Motor Vehicle Sales Authority of BC Suite 208 - 5455 152nd Street, Surrey, BC V3S 5A5, or

By fax to: 604.574.5883 If you have questions regarding completing this form, please visit our website at www.vehiclesalesauthority.com or contact Consumer Services at 604.575.7255 or toll-free at 1.877.294.9889. IMPORTANT

Section 1: Who is filing the complaint?

Part A

First name Last name

Address

City Province Postal code

Home phone Work phone

Cell phone E-mail


Address



Cell phone E-mail

Version 3, January 8, 2014

Version 4, January 8, 2014

: Providing false and misleading information is an offence under the Motor Dealer Act. Completing all applicable fields of this form will ensure that the VSA receives sufficient information to fully address your concern. Incomplete applications may cause process delays.

Attach required documentation:

Attach all relevant supporting documentation, including ICBC Transfer/Tax Form APV9T, worksheets, deposit receipts, ICBC vehicle damage enquiries, CarProof and CarFax reports, and other relevant documents.

. Complainant’s contact information

Complainant is the person who entered into the transaction with the dealership and whose name appears on the sale, lease, consignment or deposit agreement/worksheet.


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Address



Cell phone E-mail

Part C


Address



Cell phone E-mail

Legal authority for representation (list and attach supporting documents):

Section 2. Who is the complaint against?

Name of the company

Address


Salesperson


Year: Make: Model:

(for an RV, this is the VIN noted on your registration) (for RV’s only - this is the coach VIN)

Registration number: _____________________________________________________________________

Odometer reading: At purchase Now

Date of purchase / lease / consignment / payment of deposit:

Deposit amount: Price: (before taxes, extras)

Financed Leased Cash

With trade-in: Yes No Extended warranty: Yes No

Manager (General Sales Business )

Year: Make: Model:


Year: Make: Model:

VIN: VIN 2:

. Legal representative’s contact information (complete if applicable) Legal representative is the person legally authorized to act on your behalf.

. Helper’s contact information (complete if applicable)

Helper is the person who helped you to complete this form.

Part B

(as stated on the ICBC Transfer/Tax Form or Vehicle Registration)


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Section 5. Details of complaint

IMPORTANT: See Section 9. Terms of Reference (page 5) for information about your responsibility to provide information that is complete, true and accurate to the best of your knowledge and belief.

Additional statement attached: Yes No

Section 6. Required and supporting documents

Did you receive the following documents / information at the time of the transaction? (Please attach a copy if applicable) Worksheet Written A copy attached None N/A Deposit agreement Written A copy attached None N/A Deposit receipts Written A copy attached None N/A Sale agreement Written A copy attached None N/A Finance agreement Written A copy attached None N/A Lease agreement Written A copy attached None N/A Consignment agreement Written A copy attached None N/A Warranty information Written A copy attached Verbal None N/A Mechanical condition report Written A copy attached Verbal None N/A Vehicle history report Written A copy attached Verbal None N/A

Vehicle registration Written A copy attached None N/A ICBC Tax Transfer Form (APV9T) Written A copy attached None N/A

Percentage vehicle is / was used / intended to be used for: % business purposes % personal use

If used/intended to be used for business, specify use:

Section 4. Vehicle’s use/intended use

Please list the events related to your complaint in the order they occurred. Include names of salesperson and/or manager you dealt with. If needed, please attach a more detailed statement to this form. It is preferable to type your statement.


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Please list and attach any other documents relevant to your complaint:

Section 7. Dispute resolution

What do you want the dealership to do to resolve your complaint?

Have you made this known to the dealer? Yes In writing (Please attach a copy) No

Verbally (Who did you speak to and when?)

Did you receive a response from the dealership? Yes In writing (Please attach a copy) No

Verbally (What was the response?)

Section 8. Additional information (That will not affect your complaint)

How did you find out about the VSA?

Advertising: Print Radio TV Online Other _________________

Automotive industry: ARA CVSE NCDA RVDA Other __________________

Consumer organization: BBB Consumer Protection BC Other

Auto insurance broker BCAA ICBC Automotive dealer

Internet search News feature Personal referral Lawyer Courts Police

Other ____________________________________________________________________________________

Was this your first vehicle purchase? Yes No How did you pick the dealership that you bought from? Advertising: Print Radio TV Online Other Word of mouth Drop in Previous purchase Other _________________________________ Did you take the vehicle for a mechanical inspection prior to purchase / lease? Yes No Dealer provided Dealer did not allow


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Section 9. Terms of service Your private information

The VSA may, at its discretion, contact any third parties, whether named on this Complaint Form or not, who may have information relevant to this complaint. Such third parties include, but are not limited to, dealerships, repair facilities, law enforcement agencies, insurance companies, providers of extended warranties and other agencies as required.

Your responsibilities All information that you submit in support of your Consumer Complaint to the VSA must be true and accurate to the best of your knowledge and belief. Knowingly or recklessly providing false or misleading information is an offence under the Motor Dealer Act punishable by fine, imprisonment or to both. Being reckless is providing any type of information without concern that the information is true or not.

By signing below, I confirm that:

1. The information provided by the undersigned in support of this Consumer Complaint to the VSA is complete, true and accurate to the best of my knowledge and belief. 2. The VSA may use and disclose the information contained in this Complaint Form for investigative and statistical purposes and taking administrative action including hearings before the Registrar which are published on the VSA’s website.

Complainant

Signature:

Name: first name last name

Date: day month year

Signature:



Signature:



Complainant (if applicable)

Legal Representative for Complainant (if applicable)

Section 11. Acknowledgments and signatures

Legal Representative for Complainant (if applicable)

The information that you provide is collected in accordance with the VSA Privacy Policy and is needed for your complaint to be evaluated and for the VSA to conduct an investigation or undertake administrative action. This information may need to be shared with the dealership against whom the complaint has been made. By sending a complaint to the VSA you are authorizing the release of this information for investigative, and statistical purposes and taking administrative action including hearings before the Registrar which are published on the VSA’s website.

Section 10. Survey consent

To provide better public services in the future, the VSA conducts electronic surveys. Participation is voluntary and you may revoke your consent at any time.

Are you willing to participate in a survey?

(initials)

(email address)

No (initials)

Yes


consumer complaint form with checklist_september 10 2014

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