Help Make a Difference - Tell Us Your Story!
This is step 1 in the process needed to recall the Gen3.
Step 1 -
Step 2
-
Step 3
Thank you for taking the time to tell us about your experience with a Gen3 or other safety belt. By adding your voice, you will help to make seat belts safer. You will receive confirmation via email of receipt of your information. Please contact us at
info@unsafebelts.com
if you have any questions.
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Zip:
Home Phone:
Ext.
Work Phone:
Ext.
Fax Number:
Email:
Vehicle Information
Vehicle Year:
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
Vehicle Make:
Chrysler
Dodge
Jeep
Plymouth
Other:
Vehicle Model:
300M
Acclaim
Avenger
Breeze
Cherokee
Chrysler Town and Country
Cirrus
Colt
Concorde
Daytona
Dodge Caravan
Dodge Dakota
Dodge Durango
Dodge Grand Caravan
Dynasty
Eagle Vision
Fifth Ave.
Grand Cherokee
Imperial
Intrepid
LeBaron
LHS
Neon
New Yorker Salon
Plymouth Grand Voyager
Plymouth Voyager
Prowler
PT Cruiser
Ram Pickup
Ram Van/Wagon
Sebring
Shadow
Spirit
Stealth
Stratus
Sundance
Viper
Wranger
Did your experience include:
accident
no accident
sudden stop
no sudden stop
sharp turn
no sharp turn
child safety seat belt involved
How many times?
Have you reported this to NHTSA?
yes
no
Have you reported this to the Dealer?
yes
no
Have you reported this to Chrysler?
yes
no
Describe what happened (optional):
Enroll me automatically as a member of the "Coalition to Recall the Gen3" and "gift" me my free one-year membership in the Center for Auto Safety, including my free copies of "Lemon Times" and "The Car Book 2003"!