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Custom Order Form

Please complete this form in as much detail as possible. When finished press submit.
A sales representative will contact you as soon as possible.
Company 
Address   
City State Zip Code
Primary contact
Name    
Phone    
Fax        
Email address   
(this form cannot be processed
without a valid email address)
Other Phone 		Engineering contact
Name 
Phone
Fax    
Email address
How did you learn of Carter Motor?

Project name and/or P/N?

Description of application?

Estimated annual usage?
Target price range           
Print available? Yes No

New Design? Yes No
Approximate production start date?

Existing Design? Yes No
Present motor manufacturer?
Model?

Voltage:     VAC 50/60Hz     VDC
Motor Only

Gearmotor
Inline or Right Angle
Gear ratio if known to 1

Other
Describe:

No load speed RPM
Loaded speed RPM
@ Loaded torque Lb-In Oz-In
or
@ Rated horsepower
Loaded current AMP.
Rotation viewed from output shaft end : CW CCW Reversible

Continous duty cycle Intermittent duty cycle
Max on time minutes
Min off time minutes

Ambient temperature ° C
Operating temperature range ° C Max. ° C Min.
Environment:

Motor termination
Motor enclosure Vented w/Fan Vented w/out Fan Totally Enclosed
Motor mounting Foot Face Type?
Max motor diameter? Inches
Max motor /motor with gearbox length?(not including shaft) Inches
Output shaft diameter Inches - Output shaft extension Inches
Output shaft special configuration?

Additional comments:

If you have any additional drawings or information you would like to submit
please email them to sales@cartermotor.com



By submitting this form to Carter Motor Corporation you agree that the
contents of the form are correct and true to the best of your knowledge.
You agree to have a representative from Carter Motor contact you by
any or all means provided. If you have any questions about this form
please call 1-866-745-2100 or email sales@cartermotor.com

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