Please complete this form and send it to Universal Microelectronics.
We will provide you with a design proposal to meet your specifications.

Company

Email

Telephone

Fax

Address

City

State

Zip

Name

Title

Expected Annual Usage

1. Total output power (VA):

2. Primary AC voltage (V): , Frequency (Hz):

3. Primary excitation current (mA max.): AT Input voltage (V/Hz):

4. Secondaries voltage unloaded:

Sec.1 : %

Sec.2 : %

Sec.3 : %

5. Secondaries voltage loaded:

Sec.1 : %  AT mA

Sec.2 : %  AT mA

Sec.3 : %  AT mA

6. Primary to secondaries isolation (Vdc/Vrms):

7. Temperature rise at reted load (°C max.):

8. Size limitation (mm max.): Height Length Width

9. Terminals: P.C.Board Solder Wire Leads

10.Other Details:(Sketch Schematic & Mechanical Details)