The Canadian Motor Vehicle Arbitration Plan

CAMVAP

CAMVAP Consumer Qualification

Step Three

Qualification Worksheet

Please complete the following information accurately and in full

Name

Business Name (if vehicle is registered to a business)

Address (street, apt.)

City/Town

Province/Territory

Postal Code (e.g. A5A A5A)

Home Phone -

Business Phone (plus extension) -

Fax -

Email

Are you the registered owner of the vehicle? Yes No

Current odometer reading?

Is the vehicle used for business or commercial purposes? Yes No

What percentage is this vehicle used for business or commercial purposes?

Have you tried to resolve this issue through the court system? Yes No

Have you contacted the Manufacturer to try to resolve the issue(s)? Yes No

Manufacturer contact or file number.

Vehicle model year

Manufacturer

Make/Model

VIN-Vehicle Identification Number

Please outline the problem(s) with the vehicle that you want to go to arbitration.

Note: The dispute must either be about manufacturing defects or where you feel the manufacturer is not honouring the new vehicle warranty. This field must be completed in order to continue with the application process.

If you have any questions regarding eligibility please contact a Provincial Administrator at 1-800-207-0685.

Step Three Qualification Worksheet Please complete the following information accurately and in full
Name
Business Name (if vehicle is registered to a business)
Address (street, apt.)
City/Town
Province/Territory
Postal Code (e.g. A5A A5A)
Home Phone	-
Business Phone (plus extension)	-
Fax	-
Email

Are you the registered owner of the vehicle?	Yes	No

Current odometer reading?

Is the vehicle used for business or commercial purposes?	Yes	No

What percentage is this vehicle used for business or commercial purposes?

Have you tried to resolve this issue through the court system?	Yes	No

Have you contacted the Manufacturer to try to resolve the issue(s)?	Yes	No

Manufacturer contact or file number.

Vehicle model year

Manufacturer

Make/Model

VIN-Vehicle Identification Number

Please outline the problem(s) with the vehicle that you want to go to arbitration.
Note: The dispute must either be about manufacturing defects or where you feel the manufacturer is not honouring the new vehicle warranty. This field must be completed in order to continue with the application process.