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+1 973 575 SIBA (7422)
info@sibafuse.com
29 Fairfield Place West Caldwell, NJ 07006
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New Fuse Application & Requirements Questionnaire
Use this form for requesting samples.
Note special shipping instructions. All samples will be sent to the Rep’s office if the“note/instruction” is blank.
Company
Address
Contact Name:
Email address:
Phone Number:
Fax Number:
What is the application?
Does this have a project name associated with it?
What is the quantity potential?
What fuse are you currently using?
Is a Circuit Diagram Available?
Will you provide us with the Circuit Diagram? yes / no email or fax?
Have you considered using a competitor’s part? If so, what is the part number?
What are you protecting? Model and manufacturer:
If model and manufacture are unknown, what is the I2t (Amp2sec)?
Are approvals required? If so, please specify UL, IEC, ANSI, IEEE, CSA etc.:
What is the Operating Voltage? AC or DC
What is the Operating Current?
What is the Mounting Configuration?
What is the Maximum Available Fault Current Amps (kA ir)?
What is the Minimum Melting Current (amps)?
What are the Pulse Currents?
Time duration?
Waveform?
Is this a Repetitive Current?
What is the Cycling time?
. If it is not repetitive, what is the Current Waveform?
Are there any Extraneous Current Requirements?
What is the Ambient Operating Temperature?
Please attach the Circuit Diagram.
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