Service Form

Choose a location*:
Manchester, NH (Mack & Volvo)
Manchester, NH (Western Star & Isuzu)
Tewksbury, MA (Peterbilt & Mack)
Lancaster, NH (Mack)
Truck Model # (ex. RD688S):

Serial # (Last six digits):

VIN Number:

Give a description of the problem(s) in the space below
Example: Headlights do not work when switched into high beam.

When would be a convenient date to have your vehicle serviced?
(Please enter dates in the format xx/xx/xxxx)

Earliest Date:

Latest Date:

Name:*

Street:*

City:*

state
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ZIP:*

Evening Phone:

Fax:

E-mail Address:*

Company Name:

Company Address:

Do you have an account with us?*
YesNo

How would you like to pay for the repair or service? (Select One)*
Cash
Charge to my account
MasterCard
Visa
American Express
MackCharge
Transfer charges to the following

Mack Dealer

Will you need assistance in obtaining a rental?*
YesNo

Comments Or Questions

*required field
Please hit the Submit button only once.
It may take up to 20 seconds for the information to be sent.