Timer Design Form

Choose one of the following timer modes of Operation:

On-Delay / Delay on Make Interval Recycle / Flip-Flop Percentage Single Shot Off Delay / Delay on Break Multi Function

Choose one of the following setting Options:

Digital Analog Fixed Other

Choose one of the following mounting options:

Panel Mount Surface Mount DIN Rail Mount Other

Please provide the required Voltage

Voltage

Please provide the quantity required

Quantity

Please provide any special conditions; ie. Explosion Proof, Nema 4, etc.

Special Conditions

Any Required approvals?

Approvals

Please Describe your Timer application

Application

Your Name

Name

Company Name:

Company

Your Address

Address

City

City

State

State

Country

Country

Zip Code

Zip Code

Telephone Number

Telephone

Fax Number

Fax Number

Email Address

Email