Industrial Info Request Form

Customer Information Request Form
Industrial And Farm

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

Equipment Make
Equipment Type & Model
Year
Engine Make & Model
# Cylinders

Present Carburetor

Present Carburetor Type
# Of Barrels 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.

Please 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.