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Required Fields *

Customer Information:

Company: Date:
New Customer  Existing Customer Project Name:
City: State:   Zip:
First Name: * Phone #: *
Last Name: *
Title: Email: *

Application Information - General

Briefly describe your application:
Design Type:
Customer Supplied DesignHOB Custom DesignReverse Engineer
No Design-Catalogue/Off the Shelf Item
Battery Chemistry(Rechargeable):
Li-Ion Li-Polymer LiFePO4 Ni-MH Ni-Cad SLA
Battery Chemistry(Primary):
Alkaline Lithium Silver Zinc-Air Other (specify):
Standard Cell Size:   Other (specify):   
Pack Cell Configuration:
Cells in Series (S): Cells in Parallel (P): Other: S P
Pack Enclosure Type:
Hardshell (plastic) Soft (shrink) Metal Other (specify):
Pack Dimensions (Inches):
Length: Width: Height:
Pack Dimensions Entered Are: Approximate Maximum

Note: These dimensions represent the working area of the pack that HOB can design to. This total volume includes the cells, circuit board(s), insulators, shrink wrap and wiring as a minimum. Allow for adequate space in your device side battery compartment design to ensure proper fit.

Application Information - Electrical

Cell Parameters:
Mfg. Cell PN: Voltage (Nom.): Capacity (Nom.):
Pack Parameters:
Voltage (Nom.): Capacity (Nom.): UV Cutoff:

Note: System UV Cutoff should be set above protection circuit UV shutoff threshold.

Operating Temperatures:
Temperature (Minimum - Celsius): Temperature (Maximum - Celsius):
Pack Options (Select all that apply):
Protection Circuit Fuel Gauge Thermistor Fuse PTC/Polyfuse PEPI
Diode TCO Other (specify):
If a fuel gauge is required, indicate form:
Display (LED) SMBus I2C HDQ DQ Other (specify):
Charger Parameters:
External Charger (stand-alone) Integrated Charger (Host) Integrated Charger (Pack)
Max. Charge Current (A):
Termination Voltage (V):  Termination Current (A):
If Charger is External, list manufacturer and part number of stand alone charger or host side IC used:

Note: If you are planning on using an external stand-alone charger, at HOB's discretion, you may be requested to provide said charger for verification of compatibility with the designed pack electronics. If your charger is an IC on the host side of your device, we may request a working circuit or schematic.

Briefly describe your application load (Resistive, Capacitive, Inductive):
Discharge Parameters:
Continuous Current (A): Expected Run Time (minutes):
Peak Current (A): Duration (secs):
Inrush Current (A): Duration (secs):
        Detailed System Load Profile will be provided prior to deisgn phase

Note: The host system's load profile is important in determining the optimal circuit trip points to ensure optimal battery safety. In particular, it is critical to know if the battery pack will experience any inrush current due to system startup or power switchover events. If no load profile is provided prior to the design phase, there may additional NRE costs incurred to properly characterize the safety parameter settings during the validation stage.

Pack Termination:
Stripped Wire Harness/Connector Contacts Other (specify)
         Harness Length (Inches):
Briefly describe any special termination requirements. List manufacturer & part number(s) if applicable:

Application Information - Regulatory

Required Regulatory/Certification Tests**:
UL CE IEC 62133

    **Note: UN38.3 testing is required for all multiple cell Lithium packs. Please contact HOB for further information.

Describe any additional Regulatory Tests or Cerifications required:

Product Deliverables

Estimated Annual Usage:    /Year
Prototype Units Needed by:    Quantity:
Production Units Needed by:   Quantity:

Validation Code *  
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