Customer Time Line (fill in dates)

Question Title

* Quotation

Date

Question Title

* Prototype

Date

Question Title

* First Article

Date

Question Title

* Production Start Up

Date

Question Title

* Product Offer Suggested for this Application

Physical Parameters

Question Title

* Mechanical Requirements
Maximum Dimensions (Inches)

Question Title

* Please include a drawing or sketch, if available

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File
Electrical Parameters

Question Title

* Electrical Terminations - Line Side

Question Title

* Electrical Terminations - Load Side

Question Title

* AC Requirements

Question Title

* Frequency  (Hz)

Current (amps)

Question Title

* AC Current/Phase (amps)

Question Title

* AC Phase requirement

Question Title

* Leakage Current (mA Max. At nominal AC voltage and frequency

Question Title

* DC Requirements

Question Title

* Current (amps)

Question Title

* Number of DC circuits to be filtered

Question Title

* Insertion Loss Requirements

  Load No Load
Common Mode
Differential Mode

Question Title

* Insertion Loss Requirements - Min Frequency (MHz)

Question Title

* Insertion Loss Requirements - Min I.L. (dB)

Accessories

Question Title

* Surge Suppression

Question Title

* Circuit Breaker

Question Title

* Current Rating

Question Title

* Voltage Rating

Question Title

* Vendor

Question Title

* P/N

Question Title

* Switches

Question Title

* Agency Approvals

Question Title

* Contact Information

Question Title

* Target Price

Question Title

* Anticipated Year Usage

Question Title

* Life of Program

T