A	
PPP Technical Call Screening	
	
Date of call:	     		Product Line:	     	
	
Contact Name:	     	 Engineer	 Buyer	 Representative	
	
Company Name:	     		
	
Company Address:	     	Manufacturing Address:	     	
	
Division:	     	Phone:	     		
	
E-Mail:	     	Fax:	     		
	
End Use Application:	     	
	
Design:	 New	 Existing Product	Proto Type Date:	     	Production Date:	     	
	
Redesign:	 Yes	 No	AIRPAX P/N:	     	
	
Annual Volume:	     	Ramp Up Volume/Date Required:	     	
	
Price Target:	     	Samples:	 Yes	   No	
	
Quantity:	     	Date Required:	     		
	
Second Source – list other Supplier:	     	
	
Voltage Rating:	     	Current Rating:	     		
	
Handle/Actuator:	 Toggle	 Rocker	 Push/Pull	 Push/Reset	 Panel Seal	
	
Handle Color:	 Black	 White	 Red	 Yellow	  	     		
	
Termination:	 STD	 Metric	 Stud	 .250 QC	 Screw	 Fuse Clip	 Bullet	
	
Mounting:	 Panel	 Front	 Back		
	
Auxiliary Switch Required:	 REC4(.110)	 REC5(.187)	 RS	 RLS	 M/T	
	
Agency Approvals Required:	 UL	 489	 1077	 CSA	 VDE	 CE	  	     	
	
Comments:       	
	
CSR Name:	     	MKT Engr. assigned to:	     	
	
Response Requested Within:	 1 Day	 2 Days	 3 Days		
	
C-5035    7/00    35417