OzBuckets :: Order Form

OzBuckets.com.au

PH 1300 246 009

CUSTOMER INFORMATION
Company *				Order # *
Contact *				Mobile
Address *				Post Code
Phone *		Fax *		Email*

MACHINE SPECIFICATIONS
Make		Colour
Model		Type of Hitch
Capacity	ton

PICKUP MEASUREMENTS (refer to drwg)
A	Pin Diameter	mm
B	Inside boss	mm
C	Pin Centers	mm

CROWD (refer to drwg)
More
Standard
Less

PRODUCT ORDER
PRODUCT DESCRIPTION	Qty	Item Price ex GST	Width (refer dwg)		Bolt on Edge	Side Cutters	Pin Requirements
			Width (refer dwg)				Welded In	Removeable		Qty 0, 1 or 2
			Nom D (mm)	Dig E (mm)			Welded In	Bolt & Nut	Circlip	Qty 0, 1 or 2

DELIVERY OR PICKUP INSTRUCTIONS

Authorised By Customer	Name *	Date *
		Ver Code *
please enter the verification code (case sensitive) fields marked with * are mandatory

Click Here To Download And Print Order Form