LOGO_LNS.gif (1293 bytes)LOGO_PLN.gif (8527 bytes)EECI-2.gif (5889 bytes)LOGO_LNS.gif (1293 bytes)QS9000.gif (2049 bytes)LOGO_LNS.gif (1293 bytes)

(Note: Fields marked * are required entries.)
Customer Information
  Company  
  *Name *  
  *Email *  
  Address  
  City  State ZIP 
  *Phone *  
  Fax  
Board Information
  Order Type    
  Part Number  
  Revision  
Dimensions
  Length (inches) Width (inches)
  PCB Thickness Layers  
  Other Thickness Specify Other Layers Specify
Holes
  Total quantity of Holes number of different hole Sizes
  Smallest hole size # Vias
Copper (finished)
  Inner (final)    Outer (final)   
  Board Material  
Line and Space
  Minimum Line Width Minimum Space (gap)
  If Other If Other

Number of Silk Screen ("Legend") sides: Silk Color
  Solder Mask Type: Mask Color:
   Plug Vias  Carbon Ink
Surface Mount Pads
  Top Side Pitch
  Bottom Side Other Pitch
Finish Plating
  HASL (Hot Air Solder Level)  HASL Lead Free 
  ENIG (Electroless Nickle/Immersion Gold) 
  Gold (Electrolytic/Electroplated)  Immersion Silver 
  Nickle  White Tin 

  Gold Edge Connector ("Tabs"/"Fingers") on # Edges 1    2    3    4
  Total Linear In. Total Thickness Micro In.

  Selective Plating Full Body Plating
  Hard   Hard  
  Soft   Soft  
  Thickness  in Micro In. Thickness  in Micro In.
  Please provide detailed area on a separate sheet.  
Special Processing
Score/V-Groove "Jump" score # of Score Lines:
  Edge Rout ("Milling") Counter Bore or Counter Sink
  Blind or Buried Vias    

Impedance Controlled +- 5% +- 10%  
Board Layout
Individual PCB Panel (adjoined/array/pallet) Set of multiple P/N
  Array/Set # UP Dimensions x (inches)
Electrical Testing
  No Test NET-LIST Comparison
Quanity & Delivery
  Qty Required Delivery Request
  Qty Required Delivery Request
  Qty Required Delivery Request
  Qty Required Delivery Request
  Qty Required Delivery Request
Purchase Order
  PO #
Data File
  File
  Sent By    
Comments / Special Instructions