Custom Product Form Contact Name* First Last Business Name*Business Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*Contact Email Address* Preferred Quote Deadline* Date Format: MM slash DD slash YYYY ELECTRICAL SPECIFICATIONSNumber of Inputs (1-5)*Please enter a number from 1 to 5.Input 1 - Voltage Range*Input 1 - Voltage TypeACDCInput 1 - Current (A)Input 1 - Input ProtectionNoneFusedCurrent LimitedResettable FuseInput 1 - Reverse Input ProtectionYesNoInput 2 - Voltage Range*Input 2 - Voltage TypeACDCInput 2 - Current (A)Input 2 - Input ProtectionNoneFusedCurrent LimitedResettable FuseInput 2 - Reverse Input ProtectionYesNoInput 3 - Voltage Range*Input 3 - Voltage TypeACDCInput 3 - Current (A)Input 3 - Input ProtectionNoneFusedCurrent LimitedResettable FuseInput 3 - Reverse Input ProtectionYesNoInput 4 - Voltage Range*Input 4 - Voltage TypeACDCInput 4 - Current (A)Input 4 - Input ProtectionNoneFusedCurrent LimitedResettable FuseInput 4 - Reverse Input ProtectionYesNoInput 5 - Voltage Range*Input 5 - Voltage TypeACDCInput 5 - Current (A)Input 5 - Input ProtectionNoneFusedCurrent LimitedResettable FuseInput 5 - Reverse Input ProtectionYesNoNumber of Outputs (1-5)*Please enter a number from 1 to 5.Output 1 - Voltage Range*Output 1 - Voltage ToleranceOutput 1 - Adjustable Voltage?YesNoOutput 1 - Remote Sense?YesNoOutput 1 - Current (A)*Output 1 - Current Max LimitOutput 1 - Output ProtectionNoneFusedCurrent LimitedResettable FuseOutput 1 - RippleOutput 2 - Voltage Range*Output 2 - Voltage ToleranceOutput 2 - Adjustable Voltage?YesNoOutput 2 - Remote Sense?YesNoOutput 2 - Current (A)*Output 2 - Current Max LimitOutput 2 - Output ProtectionNoneFusedCurrent LimitedResettable FuseOutput 2 - RippleOutput 3 - Voltage Range*Output 3 - Voltage ToleranceOutput 3 - Adjustable Voltage?YesNoOutput 3 - Remote Sense?YesNoOutput 3 - Current (A)*Output 3 - Current Max LimitOutput 3 - Output ProtectionNoneFusedCurrent LimitedResettable FuseOutput 3 - RippleOutput 4 - Voltage Range*Output 4 - Voltage ToleranceOutput 4 - Adjustable Voltage?YesNoOutput 4 - Remote Sense?YesNoOutput 4 - Current (A)*Output 4 - Current Max LimitOutput 4 - Output ProtectionNoneFusedCurrent LimitedResettable FuseOutput 4 - RippleOutput 5 - Voltage Range*Output 5 - Voltage ToleranceOutput 5 - Adjustable Voltage?YesNoOutput 5 - Remote Sense?YesNoOutput 5 - Current (A)*Output 5 - Current Max LimitOutput 5 - Output ProtectionNoneFusedCurrent LimitedResettable FuseOutput 5 - Ripple Thermal Load PropertiesOperating Temperture RangeIndicate C or FStorage Temperture RangeIndicate C or FThermal Protection?YesNo General SpecificationsDesired Dimensions: Length x Width x Height (inches)Quantity RequiredPreferred Prototype Deadline Date Format: MM slash DD slash YYYY Preferred Manufacturing Deadline Date Format: MM slash DD slash YYYY Military Standards to be Met MIL-STD-1399 MIL-STD-461 MIL-STD-704 MIL-STD-810 MIL-STD-1399 Additional details or notesITARS Compliant?YesNoPlatform/End Use