enquiry

	CUSTOMER INFORMATION
	Name		Title
	Company		Division
	Address		Pincode
	Phone		Fax
	Mobile		Email
	MACHINE DESCRIPTION
	Machine		Model
	Machine Manufactural		Year
	Original Clutch Manufactural		Clutch No
	Disc No
	Quantity of this type of mechine in your plant
	CLUTCH DISC DATA
	Is there a manufacturing drawing available for the disc ? If so,kindly fax the same to us.if a print is not available ,please answer or check off the following question that apply to your application:
	Friction Disc:		Steel Disc
	Solid Bronza Disc
	Outside diameter of disc in mm		Inside diameter of disc in mm
	Thickness of disc in mm
	No of external gear teeth		No of internal gear teeth
	Micro finish of steel disc surfaces
	Does the steel disc have a ground finish ?		Yes No
	Is the mating spline of slotted drive cup available?		Yes No
	Is a sample of the clutch disc available for obsarvation ?		Yes No
	Quantity of discs required for replacemant ?		Yes No
	Estimated annual usage :
	Does the mating disc need to be replaced ?		Yes No