Lithium Battery Application Questionnaire

To enable Tadiran to provide the most appropriate solution to your battery requirement, kindly fill in this questionnaire with the maximum data you can provide. Your data will be treated with full confidence and be used only for optimizing our solution.

Company:

Street Address:

City:

State:

Zip:

Contact Person:

Title:

Tel:

Fax:

Email:

Application Details:

Brief Description:

Battery is used for:

Back up

Main power source

Electrical Requirements:

Operating Voltage:

Maximum

Nominal

Minimum

Constant Current:

Constant Current =

Constant Current (unit) =

Pulse Current:

Ip=

Pulse Current (unit) =

Duration:

T =

Duration (units) =

Every:

T =

Every (units)=

Pulse Load Profile: Please enclose a drawing if needed
Qualification Tests: Please enclose specifications

Expected Operating Life:

Untitled

Storage of battery before use:

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Environmental Requirements:

Storage Temperature – Please specify percentage(%) of time per temperature. Make sure it sums to 100%

Max Temp (ºC)

Average Temp (ºC)

Min Temp (ºC)

% of time at Max

% of time at Average

% of time at Min

Operating Temperature:

Max Temp (ºC)

Average Temp (ºC)

Min Temp (ºC)

% of time at Max

% of time at Average

% of time at Min

Special conditions of humidity, shock, vibration etc.’:
Please enclose specifications or list in the remarks below

Size and Dimensions of cell:

(Please attach a drawing if a battery pack is required)

Preferred Cell Size

Max. Space Available (mm):

L =

W =

H =

Estimated Annual Requirement:

1^st year

2^nd year

3^rd year

1 <sup>er</sup> year

2 nd year

3 rd year

Qty for First delivery

Expected during (Month)

Expected during (Year)

Alternative Battery:

Type

Maker

Model

Remarks:

Form filled by:

Customer

Tadiran REP.

Name:

Date:

www.tadiranbat.com

Company confidential

61000096005-Rev B

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