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BUSES
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RVs & MOTORHOMES
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410-442-7418
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Services
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Truck Repair
Bus and Coach Repair
RV and Motorhome Repair
Trailer Repair
Auto Body Repair Services
Aluminum Polishing Services
Electrical Troubleshooting & Diagnostics
Preventative Maintenance Programs
Snow Plow Repair Services
Payment
Contact / Customer Intake
Customer Intake Form
Contact Us / Inquiry Form
Home
Services
All Services
Truck Repair
Bus and Coach Repair
RV and Motorhome Repair
Trailer Repair
Auto Body Repair Services
Aluminum Polishing Services
Electrical Troubleshooting & Diagnostics
Preventative Maintenance Programs
Snow Plow Repair Services
Payment
Contact / Customer Intake
Customer Intake Form
Contact Us / Inquiry Form
Customer Intake Form
Eyre HD Customer & Vehicle
Customer Information
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Are You a Current Eyre HD Customer or a New Customer?
(Required)
Current Eyre HD Customer
New Customer
How Did You Hear About Us?
Vehicle Information
Vehicle Type
(Required)
Truck
Bus / Coach
RV / Motorhome
Vehicle Year
(Required)
Vehicle Make
(Required)
Vehicle Model
(Required)
Vehicle Color
(Required)
Vehicle Chasis
Vehicle Engine
VIN
(Required)
License Plate #
(Required)
License Plate State
(Required)
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Issue / Complaint / Comment
(Required)
Service Request Photos
Please upload photos that can help describe the need for service. If you know your photos have filenames, type the filenames into the box above.
Drop files here or
Select files
Accepted file types: jpg, gif, png, pdf, heic, heif, Max. file size: 5 MB, Max. files: 5.
Previous Vehicle Service History or Maintenance
Service Agreement
Winterization Agreement
(Required)
December 1st – March 1st: Customer understands that for liability reasons, Eyre HD requires mandatory winterization & Diesel 911 fuel treatment for all RV’s and Campers dropped with Eyre HD between December 1st and March 1st.
Customer Initials
(Required)
Date
(Required)
MM slash DD slash YYYY
Vehicle Age Agreement
(Required)
Vehicle Age and Parts Availability: Customer understands that for vehicles older than 10 years of age, Eyre HD may not be able to acquire the necessary parts to repair their vehicle. Time spent diagnosing, searching for parts, servicing, and inspecting vehicles will be paid for at the current hourly labor rate, even in the event total repair is not possible.
Customer Initials
(Required)
Date
(Required)
MM slash DD slash YYYY
Storage Fee Agreement
(Required)
Storage Fee: Customer understands a grace period of 1 week will be extended to customers, after their repair is completed and they are notified of its completion, to pick up their vehicle. Beyond that, a daily storage fee of $250/day will be charged. Eyre HD reserves the right to extend the grace period on a case-by-case basis when necessary.
Customer Initials
(Required)
Date
(Required)
MM slash DD slash YYYY
Parts Deposit Agreement
(Required)
Customer understands that a deposit of 50% parts is required prior to parts being ordered for authorized repairs. For this reason, an active credit card must be provided at time of drop-off.
Customer Initials
(Required)
Date
(Required)
MM slash DD slash YYYY
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