Company*
Date*
Telephone*
Contact Name*
Email*
Fax
 
Address*
City*
State*
Zip*
 
Application*
Customer P/N*
 
Quote on
Estimated Annual Usage*
 
Prototype Needed(when)
Production Planned(when)
 
Current Ratio*
Accuracy Class*
Burden*
Frequency*
Fax
 
Dimentional limitation (if any, sketch if available)    
System Voltage*
CT Type

Location

   
Standard
Other
 
Outer Insulation, specific requirements for plastic, If any
 
Standard
Mounting Requirement (Please specify)*
 

Please specify the following Information if available

Primary Type
Turns Ratio*
(if different than current ratio)

Continuous Thermal Current*

times at*

Temperature or R.F.*

Short time Thermal Current Ith*

kA for*

 

Peak Dynamic Current*

Ith x

BIL*

 
Insulation Class
F (155 C) H (180 C)
 

Application / Intended Use

Special requirements Viz for Label, color, unusual ambient conditions, unusual exposure climate (attach sheets)