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Contact Information

1. Unit is needed for:
New Machinery
Retrofit - to replace (Mfg., Model):

If Retrofit, why is current model being replaced?

3. Temperature Range of the destination environment:

Minimum: ( specify °F / °C )
Maximum: ( specify °F / °C )

4. Brake Mounting:

Flange Mount
        Shaft Size:  ( specify in / mm )
        Keyway: Standard or Other:  ( specify in / mm )
Thru Shaft
        Shaft Size:  ( specify in / mm )
        Keyway: Standard or Other:  ( specify in / mm )
Nema or IEC Frame
        Size/Type:

5. Orientation of the shaft on which the brake will be mounted:

Horizontal
Vertical

6. Brake Actuation Required:

Air Engaged (Brake is engaged when air pressure is applied)
Spring Engaged (Brake is engaged when air pressure is exhausted)

7. Brake Function:

Stopping
Stop Time:  Seconds,
Inertia Stopped:  ( specify lb.ft² / kg.m² )
Holding
Required Torque:  ( specify lb.in / lb.ft / Nm )

8. Motor Specs: HP:     RPM:

If not electric, please specify type here:

9. RPM at Brake:  RPM

10. Cycle Rate:  X Per Minute

11. Operating Air Pressure Restrictions (if any):

Minimum:  PSI
Maximum:  PSI

12. Space Restrictions:

Maximum Length:  ( specify in / mm )
Maximum OD:  ( specify in / mm )

Additional Information
Please include any special requirements, environmental conditions, etc.