CUSTOM AXLE ORDER FORM                                                              [BACK]   [HOME PAGE]

 FOR PRICING ON CUSTOM MADE AXLES COMPLETE THIS FORM

 Start

  Type of Rear End:
  (9"Ford, 12 Bolt Chevy, etc.) 
  You must choose one of the housing ends below left.

        Driver side Dimensions:
        C
        K

        Passenger Side Dimensions:
        C
        K
        A

 Bolt Circle  
 & Stud Type

 Screw In      Press In 
 Size or Part #  

 If using Disc brakes, list axle flange diameter needed
                J

              B 
              H
 
                         Spline Count:
    (If spool list Manufacture) 

 D Axle flange to axle flange width 
 E
 Housing flange to housing flange 
 F
 Drive side housing flange to pinion center
 G  Passenger side housing flange to pinion center 
 Type of Housing End:  
 (9" Ford, 12 Bolt Chevy etc.) 
                                                                                                         You must choose one of the housing ends above. 

  BILLING ADDRESS                                                      SHIPPING ADDRESS (if defferent than billing address)

   NAME                          NAME   
   ADDRESS                  ADDRESS 
   CITY              CITY
   STATE   ZIP             STATE  ZIP  
   PHONE NO.                               PHONE NO. 
   FAX NO.
   EMAIL ADDRESS:

 A Phone Number and Email Address is required to confrim your order for payment. Most orders are shipped within two days after orders are confrimed.

 PLEASE INCLUDE ANY QUESTIONS OR DETAILES
 

 

                

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