FCA Customer Claim Form 2025

1. Click ‘Get Form’ to open the FCA Customer Claim Form in the editor.
2. Begin by filling in your personal information. Select your title (Mr., Mrs., Ms.) and enter your first name, middle initial, last name, street address, city, state, zip code, and both day and evening phone numbers along with your email address.
3. Next, provide vehicle information. Indicate the names on the vehicle title and whether it is leased. Specify if the vehicle was purchased used and provide details such as make, model, year, delivery date, current mileage, and Vehicle Identification Number (VIN).
4. In the 'Vehicle Problem(s)' section, list any issues you are experiencing with the vehicle. Attach copies of relevant repair orders or documents that support your complaint.
5. Finally, sign and date the form. Ensure all required fields are completed before submitting it to the National Center for Dispute Settlement via mail or email.

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