ORDER FORM

Model #202 68-72 BB Chevelle

To allow us to build your header with the best possible fit, 
please print this page, complete and 
fax to:  717-854-9486 or 
mail to:  Stahl Headers Inc. 1515 Mt. Rose Ave., York, PA 17403

Year/Model  
Engine  
Cylinder Head Manufacturer/Model  
Deck Height  (stock or stock +)  
Tube Size  (tall decks or high port cylinder heads must use stepped headers)  
Collectors (state removable or fixed and outlet diameter)
Prices shown include removable collectors. 
Add $120 for fixed collectors due to cost of flanging #7 & #8		  
Fully Assembled or Partially Assembled?  
Air Conditioning No, this header does not fit air conditioning
Power Steering OK
Power Brakes OK
Oil Pan (if you have an aftermarket oil pan, please check the dimensions provided)
 		 Clearance to stock oil pan:  right = 3-5/8",
left:  measured 4" below the oil pan rail, #1 tube comes within 1- 3/16" but below that is clear
Mounts (this design will clear a mid plate also) This header is designed using stock production frame brackets and engine mounts.
Starter (we have identified 9 different gear reduction starters, therefore clearance is only guaranteed as listed) Prototyped with a large stock starter and a
Hamburger mini starter fits in the outboard position
Vehicle Modifications Cylinders #7 and #8 go out over frame
 must cut inner fenderwells

SOLD TO:

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Home Address  
City/State/Zip  
Daytime Phone #'s  

SHIP TO:

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PAYMENT OPTIONS:

Payment 
In
Full

 Include a 
CASHIER'S CHECK 
or MONEY ORDER 
with order		 Best Option!
Receive a $50 cash discount and free freight
$200 Deposit with order, balance at time of shipment Deposit by  CASHIER'S CHECK, MONEY ORDER, or CREDIT CARD 
Balance by  UPS COD		 Receive a $50 cash discount
You pay the freight
Credit Card $200 Deposit on CREDIT CARD at time of order, balance on card when shipped No discount
You pay the freight

If using a credit card, please complete the following:
CREDIT CARD INFORMATION

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City/State/Zip  
Expiration Date  
Verification Code (on back of card where name is signed, what are last 3 numbers?)