Ford Roof Crush Class Action

Form Name
Created
First Name
Last Name
Email
Phone Number
Address
City
State
State
Zip
Have you experienced a roof crush accident?
Were you or others injured?
Briefly describe injuries
Super Duty model
If other, enter model
Year of vehicle
Purchase or lease?
Date of purchase or lease

MonthDayYear
2 digit month, 2 digit day, 4 digit year
City of purchase/lease
State of purchase/lease
Dealership or private seller?
Dealership name
Do you still own the vehicle?
Current mileage
Upload relevant documents or photos for the legal team's review.

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Additional Information
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