Mr. Injector Service Form
Print this form and fill it out by hand or click here to fill out an electronic PDF form. If you choose the electronic form fill it out then print it and send it in with your injectors.
Package your injectors and send them in with this form. The pintle pins are venerable so if any of the caps are broken wrap some tape around the tip to protect it. USPS has a flat rate envelope at a discount rate. Be sure to wrap the injectors in bubble wrap.
Send them to:
Mr. Injector
6280 North Government Way #4
Dalton Gardens, Idaho 83815
Name_____________________________________
Address______________________________
City_____________________________________
State________________________________
Zip______________
email________________________________________________________
Phone________________________________
Cell_____________________________________
Make___________________________________
Model__________________________________
Year___________________________________
Engine_________________________________
Reason for service:
Maintenance________ New Engine__________ Problems__________
If you
answered problems describe the
problem__________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Total number of injectors enclosed ______________ x $16.00 per injector = ____________________
Return Shipping USPS Priority _________Add
$5.00
USPS Express _________ Add $20.00
Payment Options: Send me a PayPal
invoice________ Money order enclosed________
Visa or MasterCard
#______________________________________________________________
Expiration
Date__________________________________________________________________
Authorization
____________________________________________________________________