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Direct Forklift Service

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Repair Request

Equipment Being Serviced

* Manufacturer:
* Model:
Year:
VIN Number:
Miles/Hours:
 

Contact Information

* First Name:
* Last Name:
* E-mail Address:
* Daytime Phone:   Extension:
* Preferred Contact Time:
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Fax:
Address 1:
Address 2:
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* What kind of service do you need done?
* What time/day would you like to request your appointment?
 

Prior Service History

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Last serviced:
Work done:

 


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