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Harness Request and Order Form
 Harness information and Credit Card Authorization  . 
Customer and Vehicle Information Form

Please use fill form out with your contact information and Wiring Harness or Parts you are in need of.
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Credit Card Information:   XXXX XXXX XXXX XXXX
Exp. Date:  MM/YYYY
CVS#:  (3 Digits)
Authorized Amount:
Authorizing
Signature:
Parts Needed: Please List Parts being Ordered and Price.

Harness order notes:
Please enter Harness
as needed and Price
Per quote or request.


Enter Part and Price Below
Enter Part information and Price below
Vehicle Make:
Vehicle Year:
Vehicle Model:
VIN/Serial Number: *
Transmission:
Engine Size:
Part Needed Information

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We can locate just about anything you need!!! We make sure they are in A+ condition.
Call or Email us with your needs. Shop Line 928-632-4372 M-F 9am-5pm            Shop Tech Line 928-460-0764  24/7
wiringinfo@sspwiring.com
 sales@sspwiring.com
Mailing Address,
(USPS only)
SSP Wiring
PO Box 1313
Mayer, AZ
86333

FedEx & UPS
SSP Wiring
9467 East Valley Road, Prescott Valley AZ
86314
Copyright . SSP Wiring. All rights reserved. 928-632-4372