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RTP Logo Rome Truck Parts, Inc.
241 Dempsey Rd.
Rome, GA 30161
Custom Systems Guide
 

Manufacturer or Customer Name:

Name of Contact:

Address:
City: State: Zip:
Phone #: Fax #:


Make of Vehicle: Year: Model: Number of
Vehicles:		 Customer Prints Furnished (Y/N):
OEM or Service: Prototype Sample
Required?:		 Prototype
Qty:		 Prototype Request
Date:


Wiper System Required: Air: Electric: Voltage of
System:
Arms Required: Arc: Pantograph:  
 
Driver
Side-RH		 Passenger
Side-RH		    
   
Park Park (CW or CCW)


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