Company Name

Address Line 1

City

State

Zip

*Contact Name

*Contact Email

Telephone

Requested Delivery Date

Reference #

Type of Part Type of PartStatorRotorPoleOther

Other? Please Specify

Outer DIameter

Inner Diameter

Number of Slots

Open or Closed? Open or Closed?OpenClosed

Quantity of Laminat

Are Laminations to be Segmented? Are Laminations to be Segmented?YesNo

Number of Segmen

Slot Width

Slot Depth

Stacked? Stacked?YesNo

New Field New FieldStraightSkewed

Gage Required Gage Required 242629