Custom Tooling Request for Quotation Form

Items in RED must be filled in




Email Address:


Contact Name:

Phone Number:


Description of Tooling Requirements (Desired type of tooling - Automatic Top Feed, Automatic Bottom Feed, manual, J-Frame, etc.):

Is this tooling for an installed machine?

Is this tooling for a robot-ready machine?

Original Order Number (for replacement parts):

Haeger Model:
If Other:

MAS Size:

Fastener Information

Fastener Manufacturer: ( , PSM, Hank, Kalei, Strux, Captive, Kerb, Konus, etc. - 25 to 300 samples may be required):
Fastener Part Number: (If no part number, please attach a signed spec/tolerance sheet):

Part Information

Part Description: (Flat, Formed, Reverse flange, to be inserted in the flat, fastener near flange, etc. - part may be required.):
Part Material:

Attachment(s) (Please attach any applicable drawings of sample parts or specifications needed -- file formats such as DWG, DXF, PDF, and DOC are preferred)