Braille Battery USA Lighter • Stronger • Faster

Braille is constantly developing new technologies which enhance the performance
capabilities of its lithium ion and advanced technologies batteries. With experience in
various markets, we can work with you to supply a custom solution or adapt current
products which will be best suited for your application. Please simply complete and
submit this form or fax to +1-941-870-3381. Thank you for choosing Braille Battery

Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail

Phone Number

- Area Code Phone Number

Website:

Application

Other:

Referred By:

Maximum Voltage (V):

Minimum Voltage(V):

Nominal Voltage(V):

Nominal discharge current(Amps):

Peak discharge current(Amps):

Peak discharge current duration(Seconds):

Recharge time needed (Hours):

Capacity needed (Amp Hours):

Maximum temperature(ºC):

Minimum temperature(ºC):

Frequency:

times each

Day Week Month

Max. Dimension

Length (mm)

Width (mm)

Height (mm)

Max. Weight (Kg)

CANBus / RS485 Communication

Regeneration

(if yes, we need regeneration current & duration)

Input Voltage(V):

110v 220v 110v~220v

Charge Current(A):

Input terminal:

European US Other

Output terminal:

Certification:

CE UL Other

Other

Prototype evaluation period (weeks)

Prototype samples quantity (PCS)

Preproduction period (weeks)

Preproduction quantity (PCS)

Production quantity (PCS)

Special requirement:

Lithium Ion Battery Application Questionnaire

Battery Voltage

Capacity

Working Temperature:

Working condition

Specifications

Charger

Other information: