To:
Dale Manufacturing
attn: David "Dale" Langsather
3425 Fairhaven Avenue N.E.
Salem, OR 97301 (503) 364-8685
www.hbrepair.com
(E-Mail address: dalemfg@q.com )
Sample Order Form: (Copy into an e-mail or enclose with harmonic balancer order)
Return Address:

__________________________________________

__________________________________________

__________________________________________

My contact telephone number: (_____) _____ - ___________ (when:__________)

Car Make:____________________ Model Name::_____________________________

Year:______________ Engine size and type :_________________________________
Has the timing mark slipped from its original position? _______Yes; _______No;
____Not sure.

Insured value (if you decide you want insurance coverage:
add $ {Call for latest cost and coverage amount.):_______________________


List return shipper you request and type of service (ground, 3-day, 2-day, next-day):

__________________________________________________________

(Usually I return harmonic balancers through the post office using their medium sized flat rate box, which usually costs $12.65 and is a 2/ 3-day air service.)(8 1/2 X 11 X 5 1/2; Medium sized Flat Rate Box from post office.") (Please review shipping tips box above).

Harmonic balancer rebuild usually takes two-three business days. I return your harmonic balancer repainted (in two coats): a high quality sanding primer followed by a coat of quality gloss black, for an attractive and durable satin appearance.
:__________________________________________________

Payment options:
[ ] I will pay by my personal check, check # _______________. $_____________

[ ] I will be paying by credit card (visa, M/C, Discover, or American Express):

card #: _______________________________ expiration date(mm/yy):___________security code:________

[ ] I would prefer you call me for my credit card number when my harmonic balancer
is completed and is ready to be shipped back to me.

[ ] I have enclosed a money order or check to cover this order.
revised 4/2015
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...Please review this important shipping information (to assure your part will arrive safely). Remember, excellent packing is your best insurance!
...Click here.
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Please Note