REQUEST FOR ORDER FORM
(GEAR REDUCER)

Please fill out the following form and email it to us:

 
Brand of Gearbox:    
Type #/ Part #:
Design:
Ratio or output speed:
If speed variator:
Min. RPM / Max. RPM		 /
Horse power rating:
Input dimensions
      If female input:
                                              (shaft diameter and outside diameter of input flange)
      If male input:                        (shaft diameter and length)
Mounting type:
  If base mount:                    
  If torque arm mount:           
  If output flange mount:        

(dimensions)
(dimensions)
(dimensions)

   
Output shaft type:
  If solid:
 Output shaft height:     (dimensions)
            
General info:
  Gearbox orientation:

   Service factor required:
 
 
Special Notes regarding this gear reducer (please indicate quantities, special modification required, deliveries needed etc.)
Please fill out the following: 
Your Company Name:
Address:
Contact Number:
Type:
Nature of Business:

                                                                            

  IEC METRIC MOTORS Form