Request Form


    Application Type

    Air Conditioning?

    YesNo

    Engine Information

    Engine Size (CID or liters)

    # Cylinders:

    8 Cyl.6 Cyl.4 Cyl.Other: (please explain under information requested)Don't KnowEngine is stockEngine is modified: (Please explain under "Information Requested." If you have an aftermarket manifold, tell us whether it is spread-bore or square bore.)

    How is your vehicle used

    Stock / Daily UseOff-RoadTowingHigh AltitudeStreet PerformanceRacing Only: (please explain under information requested)

    Carburetor Type(s)

    4 Barrel2 Barrel1 BarrelDon´t Know

    Information Requested

    ATTENTION: Always disconnect your battery terminals and change fuel & air filters when a new or rebuilt carburetor is installed.