Information Request Form

WHEEL ADAPTER REQUEST

** ONLY USE IF YOU HAVE ALL INFORMATION AVAILABLE **
Name*
Address ( if shipping quote needed )

Street Address

CityState / Province

Postal / Zip CodeCountry
Phone Number : *
Phone Number*
Please enter a valid phone number.
Email : *
Vehicle's Make, Year, and Model : *
Vehicle's Bolt Pattern : *
Vehicle's Center Bore : *
New Wheel Bolt Pattern : *
New Rim's Make, Year, and Model : ( If its an aftermarket, input aftermarket )*
How many adapters ? *
Thickness of Adapters : *
Lug Nuts : ( for vehicle )*
Studs : ( for new rim, if you want to use stock lug nuts from vehicle, input the same as lug nuts )*
Hub Centric :
HC ONLY - Vehicle's Center Bore :
HC ONLY - New Rim Center Bore :
You agree that by giving all this info you are knowledgeable on wheel adapters and all info is correct. All sales are final and non returnable.
Should be Empty:

WHEEL ADAPTER REQUEST