| 443 Pitts School Rd. NW Concord, NC 28027 Tel: (704) 782-4343 Fax: (704) 782-4443 Hours: 9:00AM - 5:30PM EST Mon-Fri |
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| Phone: [WK] [HM] [FAX] | |
| Deposit: A non-refundable $2,500.00 US dollar deposit is required in cash, cashier's check or money order | |
| 5-SPEED ROAD RACING TRANSMISSIONS: Circle, check, and fill in the choices below | |||
| MAKE: Chevy Ford Mopar AMC Other: | MOTOR: Big Blk. Small Blk. |
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| TRANS: Road race: #5S-RR Special options: [_]5.5" Setback Adapter | |||
| INPUT CLUTCH SPLINE: 26 x 1.25" Dia. |
INPUT PILOTS: Ford Chevy | ||
| BEARING RETAINER FOR: Ford Chevy | |||
| SHIFTER: Yes / No [_]MV Rail Shifter #5S-RRMV-O SHIFTER SET BACKS: 19-3/16" up to 30-9/16" *If you are ordering our manual shifter, you must specify shifter location |
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| [_]MV Rail Shifter Head: #MVRAIL [_]Shifter Kit: #5SSK | |||
| [_]Roller Pilot Bearing | [_]Yoke: #1350YMW | [_]U-Joint: #1872 | |
| [_]Oil #TLQ | [_]Small Parts Kit #SPK-A5SP | [_]Sealant #90003-B | |
| EXTRA GEAR SETS: | [_] 1st Gear Set #5S1S / [_] 2nd Gear Set #5S2S / [_] 3rd Gear Set #5S3S / [_] 4th Gear Set #5S4S / |
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| Packaging and handling charges $30.00 (UPS charges additional) |
(Sales Tax is six percent (6%) for North Carolina customers, and applies when picking up a transmission or parts here in Concord, NC) |
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| Ratios Main Drive: ___/____ |
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| (For Jerico® Use Only) |
| Prices and specifications are subject to change without notice. There is no warranty, stated or implied, due to the unusual stresses on placed racing parts, and because we have no control over how the parts are installed or used. |