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Email:

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Work Phone:
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Fax:
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Street Address (required)

(UPS will not deliver to P.O. Boxes):

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City:

State: Zip:

Car Year:

Car Make:

Car Model:

Distributor Make:

Distributor Model:

Distributor Model ID #:

Engine Make (if avail.):

Engine Year (required):

Engine Displacement:

Type/No. of Cylinders:

Electrical:
6 volt
12 volt
Neg. Ground
Pos. Ground


Type/Model of Transmission:

(Furnishing this information is needed to guarantee best performance.
In many cases, we have this information but in cases where we do not have it, and you supply it, we can best meet your performance expectations!)

Work to be done:

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Notes:

Parts/materials shipped with the unit to be re-built:

Should Buffalo Machine Works supply New Silicone Heat Treated Cap and Rotor?

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