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 Personal Information
Name    
Address  
City  
State  
Zip  
Phone Number  --
Email  @
Where Did You Hear About Us?
Have You Used H.O. Before?
 Vehicle Information
Make  

 

 Convertible
Model   
Year    
Manufacture Date    (Found on door Jam)
Power Train Specifications
# of cylinders   
Type of Fuel:  

Displacement/Motor Size: 

  
Is this the original engine?:   
Pulley Type / Number of Groves:  
Drive train   
Transmission  
Air Conditioning   

 Electrical Specifications
Number of Batteries  
Your Stereo System Total Wattage  Watts
Fuse Size between Battery and Stereo  Amps
Which Best Describes Your Car
Stereo System Voltage
 Optional Information  Any Additional Notes:
Makes and Models of Car Stereo Amplifiers: 

Fuse Rating per Amplifier

 Amps

 Amps

 Amps