Items marked with * are REQUIRED
Name*
Job Title/AOR
Company*
Address*
City*
State*
Zip*
Country*
Phone*
Fax
Email*
New or Existing product line to your company
Motor Application*
Vehicle Model #
No Load Gross Vehicle Weight
Drive Wheel Diameter (inches)
Full Load Gross Vehicle Weight
Rolling Tire Radius (inches)

PLEASE PROVIDE MECHANICAL DETAILS REQUIRED OR MECHANICAL RESTRAINTS (I.E. MOTOR LENGTH, DIAMETER, MOUNTING, OUTPUT SHAFT, ETC.)
Transaxle Ratio /1

Transaxle Efficiency

%
Type of Drive Belt
Gear
Other
Maximum Vehicle No Load Speed on Level (MPH)
Minimum Vehicle Full Load Speed on Level (MPH)
Minimum Vehicle Full Speed up % Grade MPH
Battery Voltage Volts
Motor* ENCLOSED VENTILATED BOTH
(If used in multiple applications)
Motor Winding* AC DC Series DC Separately Excited PMAC BLDC


Required Information For Separately Excited
Controller Manufacturer
Part No.
Maximum Field Current
Maximum Armature Current
Operating Load Point Requested


Motor Requirements
Number of Terminals*
Requested Rotation:*
H.P./K.W.*
RPM*
Max AMPS
Volts*
Stall Torque (If required)
# Motors per year*
# Prototypes*
Rating* INTERMITTENT 1 HOUR CONTINUOUS