Please fill out ALL information in the below form to insure you receive 
the correct Spare Part (s) information. If you would like to speak to 
someone regarding  your inquiry or order, please contact our Spare 
Parts Representative (Victor International) at (973)267-8900.

Contact Information

Name
Company
Street Address
City/State/Zip code
Telephone
Fax
Email

Purchasing Contact Name (if different than above)

Spare Part Information 

Model Number (Example DS; WFS; WPS(necessary)
Can be found on face plate of machine or Operational Manual
Serial No: (ExampleW0000/Year (necessary)

Below parts must be all for the same machine listed above. If one part 
is for another Huber machine, please provide model/serial in the 
"additional info" box for that part.

Qty Huber Part No. Additional Info
Qty Huber Part No. Additional Info
Qty Huber Part No. Additional Info
Qty Huber Part No  Additional Info

(Example of Part No: Y10-0000. If known)

Is this an inquiry for pricing information, or an order? Inquiry  Order
Have you placed an order for this part before? Yes  No 
If Yes,  what is the old purchase order number? (if available)

How soon do you need the part?
Would you like to order this part by Internet or by phone Phone  Internet
If by phone, please fill out entire form and submit by fax before calling.

If ordering, please provide us with your Purchase Order No.
Orders will only be accepted once hard copy of purchase order with 
signature is faxed to VIM. 
NOTE: We will confirm by fax current pricing and delivery time.


Shipping Information (only applicable for new customers or if 
shipping instructions have changed).

Shall we ship to the above stated address?  Yes  No 
(if No, please provide Ship To address below)
Ship To Street Address (if different than above)
Note: All Ship To and Billing information must be provided on faxed 
hard copy.