Info Request Form

Customer Information Request Form

Please fill out this form completely. Tell us clearly what you need, so we can serve you better, with accurate information, specifications and prices. Each inquiry receives personal attention by our experts, and we always respond as fast as you we can. We respect your privacy, and we guarantee that we do not sell or share your personal information with anyone outside our company.

Personal Information

Name
E-Mail
Repeat E-Mail Address
Phone
Postal / Shipping Address 1
Postal / Shipping Address 2
City
State / Province
Postal / Zip Code
Country

Response Method Requested
How do you want us to get back to you?

Please contact me by	Phone E-mail
Phone number to call
Best time to call

Application Information

Type
Make
Model
Year
Computer Control?	Yes No
Air Conditioning?	Yes No
Transmission
Emissions Requirements
Type of choke

Engine Information

Engine Size (CID or liters)
# Cylinders:
Engine is:	Stock Modified

If engine is modified, please explain under "Information Requested." If you have an aftermarket intake manifold, tell us whether it is spread bore or square bore.)

Driving Requirements

If Racing Only, please explain under "Information Requested."

Present Carburetor(s)

or other:
Number of carburetors on engine (if more than one):
Brand of carburetor(s):
Carburetor # (Important if requesting rebuild kits or parts. Number is found on metal tag or is stamped on carb body)

Information Requested
Please tell us clearly and completely what you need.

Note: We recommend always changing fuel filters and air filters when a carburetor is installed or repaired.

Our business is built on a foundation of quality, service and integrity.