Service Form


Billing Information (Required information *)
First name *
Last name *
Company Name *
Return Address *
City
State
Zip
Country
Contact Phone Number
Email *
Style of Wheel (if known)
Vehicle *
Wheels Purchased From *
Repair (Please describe problem or repair) *
PLEASE NOTE: Submit this form to receive an RGA number via email. Please write this RGA number on
all boxes being returned.

SECURITY CODE

Security Code
Please type the security code as it appears on the left.
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