LHI TECHNOLOGY SAMPLE/QUOTE/DRAWING REQUEST FORM

Select Request Type
Customer
Customer Contact Name
Customer Street Address
Customer City
Customer State
Customer Zip
CustomerCountry
Requestor's Name
Representative's Firm
Approved By
Requested Date
Subject Part Number
A. SAMPLE REQUEST
Target Completion Date
B. QUOTE REQUEST
Quantity
Must Complete C.3 Component used 
C. DRAWING REQUEST
Production Drawing
Customer Spec. Number
Sample Description
1. Product Sketch Enclosed
2. Hanking Specification
3. Component Used
Plug
Plug Rating
Plug Color
Plug Approval
Cable
Cable Size & Temp
Cable Color
Cable Approval
Cable Source
Connector
Connector Rating
Connector Color
Connector Approval
Terminal
Terminal Manufacturer
Terminal Equivalent
Terminal Housing
Terminal Source
Terminal Alternative
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