Olsun Electrics Corporation

Transformer Order Form

Date:	Company Name:
Billing Address: Street Address:
City:	State:	Zip:
Ship to: Street Address:
City:	State:	Zip:
For foreign shipments please enter your address here:
Phone Number:		Fax Number:
First Name:		Last Name:
Title:		Email Address:

Delivery Date Required:	Quantity Required:
Power Rating:	Enter Rating
Motor Starting Auto Transformer: 2 coil or 3 coil (Check one) \| Medium Duty or Heavy Duty (Check One)
Phase:	Other
Frequency: Hz.	Other
Windings: Copper Aluminum
Primary Volts:	Basic Impluse Level: KV
Connections: Delta Wye
Primary Taps: FCAN	FCBN
Secondary Volts:	Basic Impluse Level: KV
Connections: Delta Wye
Secondary Taps: FCAN FCBN
Temperature Rise: deg. C. Insulation Class: deg. C.
Impedance: Standard Other
Drive Isolation:	K-Factor:
Sound level:
Impregnation: Standard VPI Epoxy Approval: UL/CSA Other: Core & Coil Only: Encapsulated: Sil Pac or Haz-Pac (Check One) Enclosure: NEMA 1 NEMA 3R Other Pad Mount: Live Front Dead Front Limiting Dimensions: "Height X "Width X "Depth Paint: ANSI 61- Grey Other Olsun Part/Design Number:
Accessories: Lighting Arresters: Distribution Intermediate Station Thermometer: Digital Type Fan Kits: Yes No Provisions Electrostatic Shield: Yes No Space Heater: Yes No Thermal Switch: Quantity: Wall Mounting Brackets: Other (Specify):
PAYMENT INFORMATION Terms: All net orders must have approved credit. Click HERE for Credit Application form
How will you be making payment?($U.S. Dollars) Open account, with approved credit! Cash in Advance Mastercard/Visa Charge Full Name: Credit Card #: Exp Date:

Shipping Information
Please sent products via:
Your UPS #: Your FEDEX #:
If other please state:
Sorry, No COD

Additional Information to assist us in quoting your order: