Customer______________________
Contact    ______________________
Address    ______________________
City &  State ____________________
Telephone _____________________
P.O. Number____________________

*Motor MFG.____________________
*H.P. _________ Frame___________
*RPM_________ Type____________
*Volts_________ Amps ___________
*Model   _______________________
*Design________ Code ___________
*S.F. __________ Rise ____________

DELIVERY INFORMATION
Coil delivery date req'd_____________
Overtime authorized      Yes        No
Ship via _______________________

Measurements taken on:
Insulated coil ___  , or Uninsulated coil ____

*NO SLOTS _______
  NO. BARS _______
  SPAN 1 & _______
*NO. TURNS _______
*NO. COILS PER SLOT _______
*WAVE OR LAP _______
TYPE COIL (FACING "COMM")
  LEFT TOP/RIGHT TOP
*LEADS TIN OR BARE
*COIL _______ WIDE X _______  DEEP
*WIRE EDGE OR FLAT
*ORIG. WIRE TYPE GLASS/FILM
*ORIG. WIRE SIZE _______ X _______
*ORIG. WIRE SIZE _______ X _______
*WT. PER COIL _______

1. *CORE DIAMETER _______
   
2. *CORE LENGTH _______
   
3. *CORE TO REAR OF "COMM" _______
   
4. REAR COIL EXT. _______
   
5. RISER WIDTH _______
   
6. RISER DEPTH _______
   
7. RISER DIAMETER _______
   
8. KNUCKLE DROP _______
   
9. MIN. DIA REAR SUPPORT _______
   
10. MAX. DIAMETER REAR SUPPORT _____
    
11. MIN. DIAMETER FRONT SUPPORT _____
    
12. MAX. DIAMETER FRONT SUPPORT _____
    
13. TOP/BOT COIL LENGTH _______
    
14. BOT/TOP COIL LENGTH _______
    
15. KNUCKLE DEPTH _______
    
16. LEAD SHANK LENGTH _______
    
17. OVERALL COIL LENGTH _______
    
18. SLOT WIDTH _______
    
19. DEPTH BELOW WEDGE ______
    
20. TOTAL SLOT DEPTH ______
    

OFFSET LEADS
YES/NO
LGTH. FROM SLOT BEND
TO REAR OF OFFSET
21. _______  25. ______
LGTH. OF LEAD REQ'D
23. _______  26. _______
HEIGHT OF OFFSET
22. _______  27. _______
ANGLE OF OFFSET
24. _______  28. _______