Name*CompanyAddress* Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Phone*Year*Make*Model*Is the cluster the original cluster for the vehicle:YesNoUnknownHave you or someone else attempted repairs?YesNoUnknownIs there physical damage to the cluster?YesNoUnknownAre the issues with the cluster intermittent or constant?IntermitentlyConsistentIf intermittent please descibe : (hot, cold, going over bumps, etc)Are the following gauges/components operating properly?SpeedometerYesNoIntermittentlyNot EquippedTachometerYesNoIntermittentlyNot EquippedFuel GaugeYesNoIntermittentlyNot EquippedTemperature GaugeYesNoIntermittentlyNot EquippedOil PressureYesNoIntermittentlyNot EquippedTransmission TempYesNoIntermittentlyNot EquippedVoltage GaugeYesNoIntermittentlyNot EquippedPRNDL (Gear Selector Display)YesNoIntermittentlyNot EquippedOdometerYesNoIntermittentlyNot EquippedLCD DisplayYesNoIntermittentlyNot EquippedAre there any other issues/problems we should be aware of?