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Required Fields *

Customer Information
Company Name
Project Name
State / Province
Zip / Postal Code
First Name *
Last Name *
Telephone Number *
E-Mail Address *

Application Information - General
Briefly describe your application
Design Type
Battery Chemistry (Rechargeable):
Battery Chemistry (Primary):
Standard Cell Size
Other (specify)
Pack Cell Configuration:
Cells in Series
Other (Series)
Cells in Parallel
Other (Parallel)
Pack Enclosure Type
Pack Dimensions (Inches):
Pack Dimensions Entered Are

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):
If a fuel gauge is required, indicate form:
Charger Parameters:
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):
Peak Current Duration (secs):
Inrush Current (A):
Inrush Current Duration (secs):

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:
Harness Length (Inches):
Briefly describe any special termination requirements. List manufacturer & part number(s) if applicable:

Application Information - Regulatory
Required Regulatory / Certification Tests:

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:
Prototype Units Needed by:
Quantity of Prototype Units:
Production Units Needed by:
Quantity of Production Units: