HBControls 221 Weaver Street, Fall River, MA 02720 - Tel.: 800-879-7918 - Fax: 508-676-7346
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Application Request

PLEASE FILL OUT THIS FORM AND SUBMIT IT
OR
DOWNLOAD THE PDF VERSION AND FAX IT TO (508) 676-7346
NAME:
COMPANY:
ADDRESS:
CITY, STATE,
ZIP:
  
PHONE #:
FAX:
EMAIL:
Brief
description
of your application:
APPLICATION DETAILS
LINE VOLTAGE:
Hz
Single Phase
3 Phase
Other
LOAD TYPE:
Resistance
(constant)
Resistance
(variable)
X-former
Motor
DC
LOAD
RATING:
Steady
 

Amps
(per phase if 3 phase)		 Inrush Amps KW    
 
SWITCHING MODE:
Zero Cross
Phase
Angle
Burst Fire
Other    
 
CONTROL VOLTAGE:
AC
DC
Variable
 
 
CONTROL CURRENT AVAILABLE:
Amps
Variable          
 
MECHANICAL
PACKAGING
Panel
Mount
Din
Mount
Other        
 
AMBIENT
TEMP.
C
F  
Max.
Temp.
ADD-ON'S

Current

Transformer
Transient Suppression
LED Indication
Diagnostic
Other
 
ESTIMATED
ANNUAL USAGE:
          
PLEASE FILL OUT THIS FORM AND SUBMIT IT
OR
DOWNLOAD THE PDF VERSION AND FAX IT TO (508) 676-7346

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HBControls 221 Weaver Street, Fall River, MA 02720 - Tel.: 800-879-7918 - Fax: 508-676-7346