Electrical Product Safety and EMC Testing First Name* Last Name* Job Title Company* Address1* State/Province* Address2 Zip/Postal Code* City* Country Phone* Fax Website* Email (required) How did you hear about our web page? GoogleGoogle Sponsored LinkBingLinkedInFacebookYahooBanner AdReferralTradeshowE-mailOther Verify Email Help Us Determine The Test Requirements What Countries/Regions would you like to Market your Product in? Check all that apply: USACanadaEuropean UnionJapanAustralia/New ZealandTaiwanKorea Other: How long will this product be on the market? Please let us know which of these environments your product will typically operate in (check all that apply): ResidentialCommercialLight IndustrialHeavy IndustrialMedicalLaboratory Other: Based on the intended use of your product, how would you primarily classify your product? Check one or two: Audio-VideoInformation TechnologyIndustrial ControlsMedicalTelecommunicationsTest, Measurement,LaboratorySecurity Other: Please place a check mark next to any specific agency certifications that you require. ULCSATUV Rheinland NRTLTUV GS Test or Bauart MarkCE Self-Declaration ReportCB ReportSEMI Other: Does your company have existing safety certifications on this product or other products? YesNo If you answered yes above, with which agencies? ULCSATUV Rheinland Others (please specify) Product Information Please provide all applicable information to help us provide you with accurate quotation. Product Description: (for example, DSL Router or 18” Heads-up Display or Small Form Factor Hologram Generator) Model Name and/or Number: (for example, CoolRareCar or XR4TI or XR4TI CoolRareCar) Other Related Information How many unique configurations are to be tested? How many modes of operation on each configuration are to be tested? Approximate set-up time for your device (in hours) Power Requirements: ACAC/DCPower Supply: DCBattery Power Phase: Single PhaseThree Phase If 3 phase, indicate DeltaY Voltage or EUT? 110V230V Other: Current Draw of your product (in Amps)? Power Frequency of your product? 50Hz60Hz Other: Number of power supplies? Are the power supplies certified? YesNo Are mains / safety critical components certified? YesNo Product Weight (in lbs.) Product Size (L x W x H in inches) Frequency of clock oscillators in your system? Frequency of highest clock oscillator in your system? How many unique interface cables are intended to be over a 3 meters length? How many of the cables listed above are unshielded? Size category: Select OptionTabletopFloor StandingVery Large Approximate weight (pounds) Is a forklift or a pallet jack required to move your device: Select OptionForkliftPallet JackBothNeither Needed Are you interested in EMC and/or Safety design consultation services? YesNo