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UMEC USA
720 W Cheyenne Ave
Suite 150
N Las Vegas, NV 89030


Ph: 702-722-6028
Fax: 702-722-6047
Power Magnetics Sample Request Form

Contact Information
Name: Company Name:
Title: Address:
Email: City, State:
Ph: Fax: Zip Code:

Project Information
Application: Project Name:
Number of Samples: Date Needed: Estimated Annual Usage:
Quote Quantity: Date Needed: Target Price:

Mechanical Information
Core Style: Max. Length: Max Width: Max. Height:
PCB Mounting (TH, SMD, Tinned Leads):

Electrical Information
Parameter Pins Tie Value Tol. Units Bias Voltage Frequency
Inductance
Leakage Inductance
Interwinding Capacitance
Self Resonant Frequency
DCR
DCR
DCR
DCR

Application Information
Topology: IC & Manufacturer:
Parameter Min Max Parameter Min Max
Switching Frequency Duty Cycle
Input Voltage Range Temperature Rise
Primary Irms Operating Temperature
OUTPUTS S1 S2 S3 S4 S5 S6 S7
DC Voltage
DC Current
Diode Type

Safety Information
Agency Approvals Required (Agency and Document #, ie UL60950):
Insulation Required (Functional, Basic, Supplementary, Reinforced):
Working Voltage (Line Voltage for Country of Deployment):
Test Voltage AC/DC Dwell (seconds) Terminals and Ties

Additional Information (Competitor Part Number, Varnishing, Special Requirements)