Custom Wheel Order Form

All fields below must be filled to submit a custom wheel quote request. Please include one wheel size per form submission and allow for 24-72 hours to receive a quote. Alternatively, you may download a PDF version of this form here. Please send the completed PDF form to sales@wsdwheel.com.

Contact(Required)

Company

Email(Required)

Phone(Required)

Date(Required)

MM slash DD slash YYYY

Size (Pallet Qty)(Required)

12 x 8.5 (48)

12 x 9.5 (48)

12 x 10.5 (48)

15 x 6 (48)

15 x 8 (40)

15 x 10 (32)

15 x 13 (24)

16 x 6 (30)

16 x 8 (25)

16 x 10 (20)

16.1 x 11 (15)

16.1 x 14 (15)

16.1 x 16 (10)

16.1 x 18 (10)

16.5 x 8.25 (20)

16.5 x 9.75 (20)

16.5 x 12 (20)

22.5 x 13.5 (20)

22.5 x 16 (12)

22.5 x 20 (12)

22.5 x 24 (12)

Other

Size (pallet quantity)

Bolt Pattern(Required)

5 – 4.5 – 3.12

6 – 6 – 4.63

8 – 6.5 – 4.84

8 – 8 – 6.01

9 – 9.5 – 7.93

10 – 11.25 – 8.66

10 – 13.188 – 11.05

10 – 5.5 – 3.66

Other

BH – BC – PH

Disc Style(Required)

Stamped (lite-duty)

3/8″ formed (heavy-duty)

1/2″ formed (heavy-duty)

Flat Plate

Bolt Hole Size(Required)

CL Offset or Backset(Required)

Valve Guard(Required)

Yes

No

Countersink(Required)

None

Field Side

Machine Side + Field Side

Other

Countersink Angle / Radius

Color Powdercoat(Required)

White

AG Cream

90% Gloss Black

Other

Quantity(Required)

Full Pallet

Other

Freight(Required)

Will Call

Delivered

Delivery Address

Signature to confirm wheel specs are accurate and WSD approval to manufacture(Required)

Wheel Photos

Drop files here or Select files

Max. file size: 250 MB.

Optional – Upload Photos of Requested Wheel to Expedite Reverse Engineering

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