Qualtek ELECTRONICS CORPORATION EMI FILTER INQUIRY Primary Power Components Division CONTACT INFORMATION: COMPANY NAME: CONTACT NAME: CONTACT PHONE #: CONTACT EMAIL: A. OPERATING SPECIFICATIONS: 1. Voltage Rating:_____________VAC 2. Current Rating:_____________A RMS 3. 4. Operating Frequency:_________HZ 5. Leakage Current:_______VAC_______HZ_______mA MAX Hi Pot Rating 9for one minute) a. Line to Ground:_________VAC b. Line to Line:____________VAC B. C. REQUIRED SAFETY AGINCIES UL CSA VDE TUV DEMKO FIMKO SEMKO OTHER ________________ SEV MINIMUM INSERTION LOSS dB (50 Ohm Circuit): MODE .01 .05 .10 Frequency - MHZ .15 .50 1.0 5.0 10 30 Common Differential D. MECHANICAL SPECIFICATIONS: L __________ mm/inch W __________ mm/inch H __________ mm/inch Termination Type: E. 1. Input: Screw Q.D. Lead Wire IEC Socket Other 2. Output: Screw Q.D. Lead Wire IEC Socket Other COMPONENT VALUE: L: __________ mH Lg: __________ µH C1: __________ µF C2: __________ µF C3: __________ µF OTHER: __________ pF F: PROJECTED ANNUAL USAGE: G: DRAWING ATTACHED: First Year _______________ Second Year ________________ Yes No Qualtek Electronics ..... Meeting Global Demands with Design Solutions. 7610 Jenther Drive Mentor, Ohio 44060 PHONE: 1-440-951-3300 FAX: 1-440-951-7252 Web: http://www.qualtekusa.com E-Mail: [email protected] Print Form Submit by Email Reset Form Form 7214