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Contact Information

 Your Name
 Company Name
 Date
 Phone Number
 Fax Number
 Address
 City
 State/Province, 
  Postal Code
 Country
 E-mail
Description of Application

Application Details

Torque Requirement   Operating Pressure  
Time Per Stroke   Time Per Cycle
(with  load)		  
Angle of Rotation Required   Type of Fluid  
Operating Temperature   Duty Cycle  
Overhung, Thrust, or Side Load (describe)

Actuator Configuration Required

Shaft Configuration:

  1V
 SE (single end) K (keyed) IS (involute spline)
  2V
 DE (double end) SS (10-B spline) Special (describe)

Mounting Type:
  End/Base Foot Flange Special (describe)
Application Sketch or Special Requirements

Instructions

Option 1: Print and fill-in the form.
Option 2: Print fill-in then fax the form to Micromatic for review.
Option 3: Fill-in this electronic version and email an attachment of your drawing.


525 Berne Street · Berne, IN · P: 260-589-2136 · F: 260-589-8966 · www.rotachydroac.com

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