ABN 77049426225 DL 14377
AUSSIE WHEEL PRODUCTS INQUIRY / ORDER FORM
NAME
ADDRESS
POST CODE
TEL (Home)
TEL (Bus)
FAX
EMAIL
DATE
Product Interested in
For Caravan/ Boat/ Other
Model selected
Hitch Mave and Type or Jockey Post
Single/ Tandem Axle
Laden Weight
Ball Weight
Slope if any
Voltage required:
12VDC or 24VDC
Type of tyre required:
standard included
Type of starter required:
standard or soft start
Length of Power Cable STD - 3.0 m
Are you fitting a battery box
Is your drive: Grass/ Gravel/ Concrete/ Tarmac/ Paving/ Other
For hitch connections please nominate distance between the underside of Chassis hitch and lowest part of chasis, not forgetting the chains if welded below chasis, to give clearance for turning (
see the sketch
)
The H value:
The L value:
Where did you hear about Aussie products?
Verbal/ Exhibition/ Website/ Magazines/ Newspape
r
If magazine or newspaper which one?
Recommendation by
Additional information
or
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