Customer Info Sheet

Company Name

Email Address

Phone Number

Capricorn Number

PO Number

ABN

Contact Name

Address

Part Details

Manufacturer

Model

Sub-Model

Engine Code

Year

Number of Cylinders

Engine Size in litres

Cylinder Configuration

Part Number

VIN Number

Body Shape

Please ensure the VIN is correct, (must contain 17 digits) and all items are filled in to the best of your knowledge
Please ensure ALL sensors - mounting brackets and heat shields are removed prior to delivery
Failure to do so may result in lost or damaged items

contact

T: (08) 6371 5039
F: (08) 92748275

Western Australia:
MTM-ICS 13 Bulbey Street
6056 BELLEVUE WA

Victoria D&D RADIATORS:
192 Duke St, Braybrook
Contact: Peter Kiley or Dave Monahan
PH: (03) 93647966

hours

Monday – 7:30 – 4:00
Tuesday – 7:30 – 4:00
Wednesday – 7:30 – 4:00
Thursday – 7:30 – 4:00
Friday – 7:30 – 4:00