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OneWheel+ XR
Please enter as much information as possible as it will help the Law Offices of Connor W. Olson to evaluate your potential claim. If information is missing, a representative may follow up with you directly to obtain the necessary information.
Your Information
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Name
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First
Last
Address
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Line 1
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City
State
Zip Code
Country
Phone Number
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Email
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XR information
Serial Number
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Date Purchased (MM/DD/YYYY)
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Purchased From
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(Please Select One)
Future Motion Website
Authorized Dealer
Third Party
Please Describe Any Issues With XR
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Mileage of XR When Issue First Appeared
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Current XR Mileage
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Repair information
Name
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Have You Sent Your XR in for Repairs?
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(Please Select One)
Yes
No
Was Your XR Repaired Under Warranty?
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(Please Select One)
Yes
No
If No, Did Future Motion Explain Why?
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additional comments
Any Additional Comments or Questions
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OneWheel+ XR