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Work Order
The Speedometer Repair Center
937 Norfolk St
San Mateo CA 94401-3536
www.speedometergaugerepair.com
Personal Information
First Name:______________________ Last Name:___________________________
Return Address:__________________________________________________________
City:______________________ State:____________________ Zip Code:___________
Cell-phone:________________________ Work-phone:__________________________
Email:______________________________________ Date:______________________
Vehicle Information
Year:_______________ Make:______________________ Model:___________________
Which gauge are you having problems with?
- [ ] Tachometer Gauge [ ]
- Speedometer Gauge [ ]
- Oil pressure Gauge [ ]
- Temperature Gauge [ ]
- Fuel Gauge [ ]
- Volt Gauge [ ]
- All Gauges [ ] (Select this option for full rebuild)
What type of problem are your gauges experiencing?
- Sticky Gauge [ ]
- Dead Gauge [ ]
- Gauge Works intermittently [ ]
- Gauge gives wrong reading [ ]
- Other (please explain)____________________________________________________ ______________________________________________________________________
Payment Options
- PayPal (Please include a copy of the paypal transaction) [ ]
- Money Order (make it payable to: Humberto Villegas) [ ]
- COD-Collect On Delivery- [ ]
($8.90 usps fee. go to www.usps.com for details) Please have Money Order payable to “Humberto Villegas“ ready at delivery time.