Please indicate the following informations
 
 

Company name
Contact person / position
Street / Number
Post code / Place
Telephon/Fax

Technical parameters
 
 

Interfaces
Mechanical dimensions
Ambient temperature	°C
Input voltage range	V
Output voltages/tolerances
Output current	A

Area of application	IndustryRailwayTelecomSpecial technologyOther
Hold up time	YesNo	Time
Galvanic isolation	YesNo	kV

Further comments
Required quantity per year
Target price	Euro
Project name

Series start

Month   010203040506070809101112

Year 200520062007