Request Service Form

    Company Name

    Customer Name*

    Phone Number*

    E-mail*

    Is Pick-up / Delivery or On-Site Service Required? YesNo

    Car Manufacturer

    Serial Number

    Have you previously purchased from CGC?

    Billing Address*

    City*

    State*

    Zip Code*

    Electric or Gas Powered? ElectricGas

    Does the car currently run? YesNo

    Service Needed*

    Security Question

    Please check your spam / junk mail if you do not receive a response within 48 hours.