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              Name: *
Street Address: *
                        
         City: *  State: *  ZIP: *
                                                                Country:
           Phone: *
               FAX:
            Email: *

REQUESTING QUOTATION FOR:

FA Series-Wire Wound     FLP Series-Metal Film     CR Series-High Power
          Wattage: *
Value in Ohms: *
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Preferred Contact Method:

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