Please fill out and submit the online form below. We will contact you regarding your submission. To print and fax this form, please click here. * Please be sure to include your name and email address. Both are required for us to receive this form. Thank you!

Name:*
Email:*
Address:
City:
State:
Zip:
Telephone:
Fax:
P.O. #:
Date:
MFG
H.P.K.W.
R.P.M.
Frame:
Volts:
Amps:
Model:
Type:
Style:
SN:

For the following measurements, please see the diagram below *
1.	Core Diameter:
2.	Iron to Riser:
3.	Length of Core:
4.	Rear Coil Ext.:
5.	Front Coil Ext.:
6.	Finger Plate:
7.	Clearance:
8.	Brush Surface:
9.	Riser Width:
10.	Riser Diameter:
*

Skewed Slots
Skewed Left:
Skewed Right:
Skew Distance:

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Indicate all slot depth in thousandths of an inch Indicate total depth and depth under wedge or band in hundredths of an inch.
Semi-Closed Slot		Depth Under Wedge		Depth Under Band
A		A		A
B		B		B
C		C		C
D

Number of Slots:
Number of Bars:
Coil Span I &:
Turn per coil:
Coils per slot:
Wave or Lap:
Right or Left top coil facing "com" end:
Leads Bare or Tin:
Wire Size:	X      X      X
	X      X      X
on Flat or Edge:
Strand Insulation:	Enamel Glass Mica
Number of Wires in Hand:
Wires in Hand Size:	Wide X High
Number of Equalizers:
Equalizer Wire Size:
Type of Insulation: (Cured or VPI)
Riser Type: (Solid or Flexible)
Weight Per Coil:
Slot Paper:
Slot Paper Size:
Swedged Leads: (Yes or No)
Swedged Leads Size	Wide X High
Number of Arm Coils with drop leads
Transposition:

Remarks:

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Universal Coil Manufacturing
2605 N Concord Rd | Belle Chasse, LA 70037
Phone: 504-367-8880 | Fax: 504-367-8960
Toll Free: 1-800-982-3390