Ford Dual Clutch Transmission Class Action Lawsuit

CLAIM FORM FOR FIRST REQUEST FOR CASH PAYMENTS FOR SOFTWARE FLASHES

If you have already submitted at least one Transmission Hardware Replacement claim that was approved by the Claims Administrator, STOP HERE. You are no longer eligible to submit a Software Flash claim.

Use this form to submit YOUR FIRST CLAIM under the Romeo Settlement for cash payments for repeated Software Flashes, which means at least one of the following labor codes or labor descriptions was performed on each of three or more Service Visits:

110333A 110405A 110513A 110524A 110902A
131102A 131104A 131108A 131109A 131110A
150090M 150090N 150090P 150090Q 150120H
160109C 160109D 160129A MT131102 R08101
14M01DD 14M01E 14M01EE 14M01GG 14M01H
120104A 130405A 130405B 130405C 130406A
130904A 130904B 130904C 140131A 140131B
140131C 140131D 140131E 150017A 150090H
150090L 150120L 150120M 150120N 150120P
150120Q 160044A 160109A 160109B R08102
R11021 14M01A 14M01AA 14M01BB 14M01C
14M01CC 14M01D 14M01L 14M01M 14M01N
14M01P 14M01Q 14M02B 14M02C 14M02D
Other Labor Description or TSB number
Background Information
Vehicle Information
Software Flashes

First Service Visit

Please enter the date of the first Service Visit on which a qualifying Software Flash was performed.

Please select the labor code or labor description for the Software Flash performed on this Service Visit (if more than one Software Flash was performed, you only need to select one labor code or labor description).

Please upload the service records for this Service Visit below.

Second Service Visit

Please enter the date of the second Service Visit on which a qualifying Software Flash was performed.

Please select the labor code or labor description for the Software Flash performed on this Service Visit (if more than one Software Flash was performed, you only need to select one labor code or labor description).

Please upload the service records for this Service Visit below.

Third Service Visit

Please enter the date of the third Service Visit on which a qualifying Software Flash was performed.

Please select the labor code or labor description for the Software Flash performed on this Service Visit (if more than one Software Flash was performed, you only need to select one labor code or labor description).

Please upload the service records for this Service Visit below.

Additional Service Visits


Please upload the service records for this Service Visit below.

Proof of Vehicle Ownership At Time of Transmission Hardware Replacements
Upload Supporting Documentation

Maximum file size: 5 mb

Allowed file types: .jpg, .jpeg, .tif, .tiff, .gif, .png, .pdf, .xlsx

Declaration and Affirmation Under Oath

If the information or documentation you provide is incomplete, your claim may be rejected.

Required