DEALER REQUEST FORM

 Chassis Dealership  Parts Dealership

Company Name: *
Contact Name: *
Company Address: *
Company City: *
Company State: *
Company Zip: *
Company Country: *
Company Phone: *
Company Fax: 
Company Email: *
Company Reseller ID#: *
Years In Business: *

Description of Business and What Products Would be of Main Interest in Your Market Area: *
With the information provided above, we also need a copy of your resellers permit. So please fax a copy of the permit to 800-779-6461.

With the information provided above, we also need a copy of your resellers permit. So please fax a copy of the permit to 800-779-6461.


Please help us combat spam and type in the words you see above to complete your inquiry.





Lefthander Chassis, Inc.
13750 Metric Rd. Roscoe, IL 61073
Phone (815) 389-9999   Fax (800) 779-6461
Return/Refund Policy - Privacy Policy
Office Hours:
8:30am - 5:00pm CST
Counter Hours:
Mon-Fri 9:00am 5:30pm CST