Information that will be needed to list equipment

Contact Information Date_____________

Name_________________________

Address________________________________________

Phone________________________

Fax___________________________

E-Mail_________________________

Make of Machine__________________________________

Model____________________________________________

Year Mfg._________________________________________

Car Count_________________________________________

Astromatic, Inc. 3194 FM 1694 Robstown, TX 78380, Ph: 361.387.1357 FAX 361.387.0179 Toll Free: 1.800.327.1357 sales@astromatic.com