****Complete all applicable information****
Print and fax this form to Toll Free 1-800-431-2906 or 615-595-6982
TAT Privacy
Statement
Please Indicate How You Want to Receive Information: (place an "x" in one of the four selections).
Email____ US Mail_____ Fax______ or Telephone______
Date_____________ Time______________
Name_______________________________________________________________
Mailing Address______________________________________________________________
City:_____________________________State:_________Zip:__________________
EMail Address: ________________________________________________________
Telephone Number: (______)_____________________________________________
Fax Number: (______)______________________________________________
Vehicle Identification Number (VIN) - (17 digits on most vehicles) -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- (located on the left upper instrument panel -dash- and visible from outside the vehicle looking thru the windshield)
Year:________________ Make:__________________________
Model:________________________________________________
Engine Size:______________Transmission Type: Automatic:_____ Manual:_____
Fuel System: ( fuel injected, carbureted, diesel, etc. )_______________________
Air Conditioning: (Y/N)__________________
Optional Information (if necessary):________________________________________
Please send me information on:
Price for the Email, US Mail, and fax service is $19.95 per vehicle. This includes research and documents up to 10 pages. Each additional page will cost $1.75. A shipping and handling charge of $1.00 will be added to the US Mail cost.
Please contact me if the cost will be more than $_________________.
The price for live telephone information is $3.50 per minute. Just call 1-800-636-6414 or 615-595-6974 Monday-Friday, 7AM-7PM CST. Have your credit card # number available.
American Express/Visa/MC/Discover#: _____________________________________ Secure Card Number ______
Expiration Date: Month____________ Year___________
Billing address if different from shipping address: ______________________________
City _____________________ State ___ Postal Code/Zip ________
Fax form to: 1-800-431-2906 or (615)-595-6982.
TAYLOR AUTOMOTIVE TECH-LINE
153 Polk Place Drive
Franklin, TN 37064-5736
Phone: (615)-595-6974