Gold Technologies, Inc.

Load Board Request Form

Customer's Contact information:
Name:
Company:
Address 1:
Address 2:
City:
State:
Zip Code:
Country:
Phone:
Fax:
Email:
How did you hear about us?	Colleague Internet Magazine
	Other:

Information Required for designing of LoadBoard:

Project:

1) Tester Model: Other:

2) Tester Channel available: Other:

3) Tester Channel assignment:

4a) Device Package: Other: 4b) Pin / Ball Count:

4c) Pitch between pins/balls: Other:

5a) Number of site: 5b) Pin / Ball Count: Other:

6) Is Schematic or Pin Description electronic file available:
Yes, please attach (pdf, dwg, dxf, jpg) 1 meg max

Not available

7a) Test signal type: 7b) Power Supply:

8) Highest speed/frequency for test: list relative Device pin nos. or group:

9) Number of Differential Pairs: list relative Device pin nos.:

10a) Number of Power Supply: 10b) Power supply assignment:

11) Test Temperature: Other:

12) PCB Material: Other:

13) Traces on Top / Bottom layers:

Components and Others:

14) Socket Manufacturer: Socket Part Number:

15) Socket drawing in PDF available:
Yes, please attach (pdf, dwg, dxf, jpg) 1 meg max

Not available

16) Handler Model: handler process: Other:

17) Docking Plate or Socket base mounting hole size & location :
Other:

18) Are components from Goldtec: Yes No
Component assembly required
Check components that are from Goldtec:
Socket        Relay
Adapter        IC
Stiffner         Transformer
Cap Resistor Other:

19) Quantity on PCB required: Other:

20) Delivery: (note-1): Other:

Special requirements / comments / instruction:

note-1 Delivery day counting started from the day all information and PO received.

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