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AFTERMARKET CUSTOMER SERVICE

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Trademarks, brands, and names depicted herein are the property of Cummins-Meritor. or its affiliates.

VMRS™ and/or this Product, as applicable, is a product of the Technology & Maintenance Council d/b/a American Trucking Associations.

*MANDATORY FIELD
PO Number		Exchange Number(Cummins-Meritor Assigns)
*Dealer Name		*Dealer Code
*Shipping address		*Ship Via
*City		Dealer Comments
State/Province: Zip
Same as Shipping Address		Upgrade if Applicable
*Billing Address		Aluminum Carrier Pump DCDL
*City		Other, Specify
State/Province Zip		*Email Address
*Dealer Contact		*Phone number
Dealer Phone Number

* Truck Manufacturer(OEM) (Check One)
	CATERPILLAR	FREIGHTLINER	PETERBILT	HINO
	INTERNATIONAL	WESTERNSTAR	MACK	KENWORTH
	VOLVO	STERLING	None

*Vin Num		*Vehicle Mileage
*Purchaser Of Truck		*Vocation
*Purchaser Address		*Engine Torque
*Lowest (Slowest) Forward Trans. Ratio (locate on OEM build sheet under Transmission)		Manual Trans. Or Automatic Trans.
*Tire Size.

FOR Cummins-Meritor USE ONLY
APPROVED BY (SPECS)		AXLE SHAFTS IF NEEDED
APPROVED BY (CUSTOMER SVC):		AXLE SHAFTS IF NEEDED
PRESENT CARRIER FORWARD REAR		CARRIER NEEDED FORWARD REAR
PRESENT CARRIER FORWARD REAR		CARRIER NEEDED FORWARD REAR
PRESENT CARRIER FORWARD REAR		CARRIER NEEDED FORWARD REAR
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