CUSTOMER & VEHICLE INFORMATION

The details
behind the repair.

Complete the customer, billing and vehicle details below, or download the fillable PDF. Send one truck per form. A-1 will contact you to confirm service arrangements.

Fields marked * are required. Provide a phone or cell number.

Customer details

Company name

NSC Number

First name

Last name

Phone

Cell phone

Please provide at least one phone number.

Billing address

Country

Address name / label

Street address

Street address 2

City

Province

Postal code

Format: A1A 1A1

Unit identification

Unit / fleet number

Year

Make

Model

VIN

Truck type

Colour

Licence plate number

Plate country

Province

Enter all 17 characters. VINs use letters and numbers, excluding I, O and Q.

Engine & operating details

Engine make / model

Engine serial number

Distance driven (km)

Distance unit

Engine hours

Transmission make / model

Distance defaults to km for Canada and Mexico, and miles for the United States. You can change it to match the odometer.

Repair concerns & notes

Describe the service needed, symptoms, warning lights or other useful unit details.

Service details

For other equipment without a 17-character truck VIN, use the contact page or call the shop.

Submitting this form does not book an appointment or mobile dispatch. The shop will confirm arrangements with you.

Need a hand?

For questions about the form or time-sensitive service, call the shop.

(519) 680-1939

Prefer the PDF?

Complete the fillable PDF and return it by email. If you don’t have a PDF reader, use the form here.

Download fillable PDF

Email the completed form ↗

The detailsbehind the repair.

Before you send

Need a hand?

Prefer the PDF?

The details
behind the repair.