Design Inquiry Form - Power Products Survey

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* First Article

Date / Time

Date

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* Production Start Up

Date / Time

Date

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* Product Offer Suggested for this Application

Custom Assembly (Designed to meet your specific requirements)

Power Entry Filter (Lower Cost Commercial Application)

High Current Single/Dual Line Feed Through Filter

Physical Parameters

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* Mechanical Requirements
Maximum Dimensions (Inches)

Length

Height

Width

Maximum Weight

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* Please include a drawing or sketch, if available

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Electrical Parameters

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* Electrical Terminations - Line Side

Connector

Studs

Pigtail Leads

Terminal

Block

Other

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* Electrical Terminations - Load Side

Connector

Studs

Pigtail Leads

Terminal

Block

Other

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* AC Requirements

120VAC

250VAC

Other (please specify)

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* Frequency (Hz)

400

Other (please specify)

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* AC Current/Phase (amps)

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* AC Phase requirement

Single

Three

Delta (3 wires)

Wye (4 wires)

Other (please specify)

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

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* DC Requirements

28 VDC

270 VDC

Other (please specify)

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* Current (amps)

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* Number of DC circuits to be filtered

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* Insertion Loss Requirements

	Load	No Load
Common Mode	Common Mode Load	Common Mode No Load
Differential Mode	Differential Mode Load	Differential Mode No Load

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* Insertion Loss Requirements - Min Frequency (MHz)

Common Mode

Differential Mode

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

Common Mode

Differential Mode

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* Surge Suppression

Yes

Define

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* Circuit Breaker

Yes

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* Current Rating

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* Voltage Rating

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* Vendor

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* P/N

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* Switches

Lighted

Non-Lighted

Remote

None

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* Agency Approvals

CSA

TUV

Other (please specify)

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* Contact Information

Name *

Company *

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address *

Phone Number

Design Inquiry Form - Power Products

Customer Time Line (fill in dates)

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* Quotation

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* Prototype

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* First Article

Question Title

* Production Start Up

Question Title

* Product Offer Suggested for this Application

Question Title

* Mechanical RequirementsMaximum Dimensions (Inches)

Question Title

* Please include a drawing or sketch, if available

Question Title

* Electrical Terminations - Line Side

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* Electrical Terminations - Load Side

Question Title

* AC Requirements

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* Frequency (Hz)

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* AC Current/Phase (amps)

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* AC Phase requirement

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* 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

Question Title

* Insertion Loss Requirements - Min Frequency (MHz)

Question Title

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

Question Title

* Surge Suppression

Question Title

* Circuit Breaker

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* Current Rating

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* Voltage Rating

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* Vendor

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* P/N

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* Switches

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* Agency Approvals

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* Contact Information

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* Target Price

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* Anticipated Year Usage

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* Life of Program

* Mechanical Requirements
Maximum Dimensions (Inches)