Design Request Form for Multi-Disc Brakes Customer/Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Enter Email Confirm Email PhoneFaxName of person requesting analysis* First Last Your Title Application (Model # and description or function) Model # of existing brake being used Manufacturer of existing brake being used Expected sales volume - 1st year Expected sales volume - 2nd year Expected sales volume - 3rd year Please select which method of measurement you are using.* Imperial/US Metric VehicleTotal weight unloaded (lbs)Total weight unloaded (kg)Total weight loaded (lbs)Total weight loaded (kg)Front wheel weight unloaded (lbs)Front wheel weight unloaded (kg)Front wheel weight loaded (lbs)Front wheel weight loaded (kg)Rear wheel weight unloaded (lbs)Rear wheel weight unloaded (kg)Rear wheel weight loaded (lbs)Rear wheel weight loaded (kg)Center of gravity height unloaded (in)Center of gravity height unloaded (m)Center of gravity height loaded (in)Center of gravity height loaded (m)Wheel base (in)Wheel base (m)Total number of wheelsTotal number of braked wheelsNumber of braked wheels in frontNumber of braked wheels in rearTire Rolling Radius (R¹) - Front (in)Tire Rolling Radius (R¹) - Front (m)Tire Rolling Radius (R¹) - Rear (in)Tire Rolling Radius (R¹) - Rear (m)Gear Ratio Wheel-to BrakeBrake locationIn-wheelDrive-lineOtherIf other, please explain Brake expected stop surface Description of worst case enviornmentDesired Braking Performance of VehicleBrake application Service brake Park brake Emergency stop Emergency stop on grade Holding brake Other If other, please explain Number of brakes needed per vehiclePark Brake RequirementsForward grade (%)Forward grade (degree)Reverse grade (%)Reverse grade (degree)Duty CycleMaximum stops per hour@ (mph)@ (km/h)Stop distance (ft)Stop distance (m)Deceleration (ft/sec²)Deceleration (m/sec²)Maximum Vehicle Speed (Unloaded)Maximum vehicle speed (unloaded)Maximum vehicle speed (unloaded)Stop distance (ft)Stop distance (m)Deceleration (ft/sec²)Deceleration (m/sec²)Maximum Vehicle Speed (Loaded)Maximum vehicle speed (unloaded)Maximum vehicle speed (unloaded)Stop distance (ft)Stop distance (m)Deceleration (ft/sec²)Deceleration (m/sec²)Drive-through requirement (Hold max driveline torque) Yes No CommentsAny standards that apply to this application Customer's calculated torque requirement General Application DataHydraulic motor model # Hydraulic motor manufacturer SAE mounting designation: A,B, etc Other 2-bolt 4-bolt Shaft size & configuration Spline Key Torque (in.-lb) Torque (Nm) @ PSI (maximum) @ BAR (maximum) Maximum speed (RPM) Loop type Open Loop Closed Loop Gear reducer model # Gear reducer manfufacturer Reduction ratio SAE mounting designation: A, B, etc. Other 2-bolt 4-bolt Gear reducer input shaft requirement Brake OperationType: Charge Pressure System Pressure Other Maximum pressure seen at brake (PSI) Maximum pressure seen at brake (BAR) Minimum pressure seen at brake (PSI) Minimum pressure seen at brake (BAR) System bar pressure (PSI) System bar pressure (BAR) Dry Oil immersed Flow-through Type of oil used to release brake Type of oil immersed or flow-through Additional commentsCAPTCHANameThis field is for validation purposes and should be left unchanged. 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