Basic Information

First Name*

Last Name*

Title

Company*

Address Street

City

State/Province

Zip Code

Email

Fax

Dimensional Requirements

Shaft:

Diameter:

Material:

Surface Finish:

Housing:

Diameter:

Material:

Surface Finish:

Axial Length for Seal (Rotor and Stator):

Operating Conditions

P1

P2

Name/Specification of Fluid:

Name/Specification of Fluid:

Pressure Min:

Pressure Max:

Pressure Normal:

Pressure Static:

Pressure Min:

Pressure Max:

Pressure Normal:

Pressure Static:

Temperature Normal:

Temperature Min:

Temperature Max:

Temperature Normal:

Temperature Min:

Temperature Max:

Shaft Speed Normal RPM:

Shaft Speed Max RPM:

Shaft Movement Axial:

Shaft Movement Radial:

Maximum Allowable Leakage Rate

End Use / Application

Account Type: —Please choose an option—IndustrialHigh PrecisionAerospace

Product Platform/Program:

Type of Secondary Power System or LRU:

Estimated Annual Volume:

Customer and/or Regulatory Requirements

Remarks