Firestone Bridgestone Wilderness ATX tires death or injury

Pearson and Pearson
A Professional Corporation
1330 Post Oak Blvd - Suite 2900
Houston, Texas 77056
(800) 447-6443
(713) 739-8600

Rollover and Tire Failure
Questionnaire

First Name MI Last Name

Social Security No.

Driver's License No. State D.O.B.

Spouse's First Name MI Last Name

Spouse's Social Security Number

Spouse's Driver's License No. State D.O.B.

Residence Address

City/State ZIP

County

Home Phone Number with area code

Business Phone

Spouse's Business Phone if different

Fax Phone

Email Address (very important)

Have you experienced a loss (personal or property) due to any of the following? (please check)

One Vehicle Collision	Date of Event
Two Vehicle Collision	Date of Event
Rollover	Date of Event
Blowout	Date of Event
Tire Tread Separation	Date of Event
Other	Date of Event

When reporting a tire failure or rollover, it would be helpful if you are able to provide us with the following information:

Describe what happened, you were driving down the road and .....
How did you know you had a tire or balance problem?
How many people were in the vehicle?
Was anybody hurt or killed?
Do you know what kind of tires were on the vehicle? (Firestone ATX, Firestone Wilderness, Goodyear Wrangler, etc.)
What vehicle was involved? Make, Model, and Model Year. (example: 1997 Ford Explorer, 1995 Chevrolet Blazer, etc.
If you have your vehicle identification number (VIN), it is helpful. The VIN is located at the base of the driver's side of the front windshield and is 17 characters long. It is also located on the sticker in the vehicle, usually in the driver's door jam. you may also find you VIN on your car insurance card, insurance paperwork, and/or your state motor vehicle title.
Were the tires original equipment (sold on the vehicle when it was new) or aftermarket?	Original Equipment Aftermarket
When did the tire failure occur? Date of incident:
Were there any other possible causes for the accident? (example: rain, secondary collision, DWI/DUI, other.)
About how many miles were on your vehicle? Approximate vehicle mileage:
About how many miles were on your tire? Approximate tire mileage:
How fast were you going? Approximate speed at the time:
Can you get the DOT# off of the tire that failed [On tire involved in the recall, the DOT number is located on the blackwall side of the tire, under the F in Firestone, and it is 10 characters long, and it starts with DOT..., on other tires it is located on at least one sidewall of the tire (please note if your tire is still on the vehicle, it may be on the inner sidewall) and it always begins with the letters DOT] (example: DOT# VDHL1PM046.) Note: Beginning in the year 2000, tires have an 11 digit DOT number (example: DOT#VDHL1PM0400.)
Can we get your tire size? (examples: P235/75R15, LT 255/75R16, P255/70R16, 31X10.50R15LT, etc.)
Location of tire on the vehicle: Which tire was it? (example: driver's side rear tire)
Do you still have the tire and/or the tread (if the tread separated)?
Have you contacted your dealer (e.g., ford, Toyota, etc.) or the tire store (i.e. Firestone, Goodyear, Michelin, etc.) or your insurance company? What did they say?
Do you have a police report, photographs, or any other evidence of what happened? Is it possible to get a copy?

The undersigned certified that all of the information given is true and correct to best of his/her knowledge. I/We understand that all Pearson & Pearson, P.C. ("P&P") is agreeing to at this time is to look at your case and that by completing, filling out, and submitting this form to Pearson & Pearson, P.C. no Attorney-Client relationship is yet formed.

Until P&P agrees to accept this case, and a written contract is executed by both the undersigned and P&P, P&P can and will take no action to protect our rights. We also request P&P, or any other law firm working in conjunction with P&P, to review this material and to call/contact us to discuss this matter further.

The "Legal Notices Section" of the P&P Homepage is incorporated and is agreed to

date submitted to P&P:

Pearson and Pearson
A Professional Corporation
1330 Post Oak Blvd - Suite 2900
Houston, Texas 77056
(800) 447-6443
(713) 739-8600