Lift Axle Request

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Lift Axle Request Form

Lift Axle Request Form

Name *

First

Last

Company

Email *

Vehicle (Year, Made, Model)

(Vertical Width Company

Single Axle or Tandem Axle (Drive)

• Single Axle
• Tandem Axles
• Other

Suspension on Drive Axle(s)

• Leaf Spring
• Air Ride
• Other

Steerable or Non-Steerable

• Non-Steerable
• Steerable

Tag or Pusher Lift Axle

• Pusher Lift Axle
• Tag Pusher Axle

Frame Width at Lift Axle Location (inches)

Frame to Ground (Vertical Distance in Inches)

Bottom of Frame to Bottom of Drive Shaft (Vertical Distance in inches)

Complete Tire Size to Run on Lift Axle (11R22.5, 295/80R22.5, etc)

Addtional Information or Request

Submit

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