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* required field

*Name:

*Email:

*Phone # :

Fax #

*Address:

*City:

*State:

*Zip:

*Country:

Make of Boat:

Length:

Boat Max Speed:

KTS / MPH

Hull Type:

Planning Displacement Towing

Engine Model:

Top RPM:

Horsepower:

Transmision Make:

Reduction Ratio:

Flange Diameter:

Bolt Circle Pattern:

Pilot Diameter:

Propeller Shaft Diameter:

Engine Weight:

Weight with Transmission:

%Front:

%Rear:

Operating Angle of CV Joints:

#1:

#2:

Commercial or Pleasure Use:

Commercial Pleasure

Distance Between Transmission
Flange and Shaft Log:

Seasonal Usage
(approximate hours):