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    Quantity required / period (*)

    /

    Rated power (VA) (*)

    VA

    Stabilizer type

    Input Isolation transformer (*)

    Number of the phases (single phase or three phase) (*)

    Rated Frequency (Hz) (*)

    Max input voltage (Vrms) (*)

    V

    Min input voltage (Vrms) (*)

    V

    Output rated voltage (V) (*)

    V

    Output accuracy

    +/-

    %

    Class of protection

    Grade of protection IP

    IP

    More information of particular needs (**)

    CONTACT INFORMATION

    Name and Family name (*)

    Company (*)

    Address, Street (*)

    City (*)

    Tel.

    Fax

    e-mail (*)

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    ** More information if needed:
    Isolation voltage
    Special connections (specify type, size, position)

    ** Environmental information:
    Ambient temperature (ºC or ºF)
    Cooling type (Air natural –AN-, Air forced -AF-)

    ** Mechanical information:
    Max sizes (depth, height, width) Particular mounting conditions
    Costructions type (open, closed)
    Particular marking requests (logos, danger information...)

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