Customer Name.........____________________________________________
Customer Address......____________________________________________
Contact...............____________________________________________
Telephone Number......____________________________________________
Fax Number............____________________________________________
Quantity.............._____________
Order or Quotation...._____________
Axle Capacity........._____________
Axle Series..........._____________ (9, 10, 11, 12, 13)
Spindle Type.........._____________ (BT, BTA, UHI, or 13HRM)
Brake Flange.........._____________ (Yes or No)
Hub Face.............._____________
Outside Bracket......._____________ (Same as Outside of Frame)
Hole Centers.........._____________
Bracket Type.........._____________ (Standard, Low Profile, or High-rise)
Starting Angle........_____________
Camber................_____________ (Yes or No)
Axle Type............._____________ (Beam Only, Idler, or Brake)
Painted Black........._____________ (Yes or No)
Sure Lube............._____________ (Yes or No)
Bolt Pattern.........._____________ (440, 545, 550, 555, 655(H), 865)
Mounting Style........_____________ (Drilled and Tapped or Studded)
Brake Type............_____________ (Hydraulic, Hydraulic Free Backing, or Electric)
Tire Size............._____________
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