Deltrol Controls
 
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Relay Application Form

The following application sheet is designed to assist us in providing the relay best suited to your requirements. It is very unlikely that you would be able to provide all the information asked for below, however any known requirement should be indicated.

Please fill in information below. Fields marked with * are required.

Anticipated Usage:

Customer P/N:

Application:

Customer Print Attached: Yes   No

Reference P/N:

Type:

Except:

Size:
Length
Height
Width

Enclosure:

 Open
Closed
Sealed
Other:

Mounting:

 Socket
Pin
Tapped Core & Locator
Other:

Terminal Type:

 .187 Q.C
.250 Q.C
Solder Lugs
Screw
Printed Circuit Board
Leads
Other:

Coil Voltage:
Nom
Min
Max

Coil Current:
Nom
Min
Max

Coil Power:
Nom
Min
Max

Coil VA:
Nom
Min
Max
Coil Hertz (AC Only): Hz

Coil Enclosure:

 Encapsulate
Tape Wrap
Other:

Coil Terminals:

 .187 Q.C
.250 Q.C
Solder Lugs
Screw
Printed Circuit Board
Leads
Other
Insulation Class:
Ambient Temperature: Max.  Min.
Max. Coil Temperature Rise:
Coil Resistance and Tolerance:
Pull-In Voltage: Max.  Min.
Pull-In Current: Max.  Min.
Drop-Out Voltage: Max.  Min.
Pull-Out Current: Max.  Min.
Contact Arrangement:

Contact Type:

 Ag
AgCdO
Tungsten
Other:

Contact Finish:

 None
Ag Flash
Au Flash
Au Soak
Other:
Contact Life Expectancy:
Load Type:
Load Voltage:
Max Inrush and/or Steady State Current:

Load Duty Cycle:
Cont
Int
On
Off

Relay Duty Cycle:
Cont
Int
Int
On
Off
Environmental Conditions: Normal  Dusty  Moist 
Dielectric Strength VRMS:
Contacts to Frame
Contacts to Contacts
Coil to Frame

UL Recognized
CSA or cUR Certified
European Notified Body Certified
CE Marking
Special Requirements:
Finish
Shock/Vibration
Operate/Release Times

Other

*Name

Company

Address

City

State

Zip

Telephone

Fax

*E-mail
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