Please submit one form per Lead-Free part request. Use this form only for Lead-Free Sampling requests. All samples are provided on an as-is basis and fullfillment on acceptance of sample requests is subject to the sole discretion of semipower. Samples are to be used solely for informational purposes and may not be used for re-sale or operational use. Submission of this sample request form does not guarantee the fulfillment of this sample request. SEMIPOWER reserves the right to change the terms of it's sample policy without notice at any time. * Required field

Sample Request
*Device Type	Mosfet Ic Diode Other
If other
*Package Type	TO-92 TO-126 TO-220 TO-220F TO-251 TO-252 TO-262 TO-263 TO-3P DIP-8 SOP-8 Other
If other
*Pin Count	3 4 8 20
If other
*Part Number
Quantity Requested	(Quantity must be between 50 and 999.)
Required By
Reliability Requirement
Quality Requirement	Consumer Industrial Other
If other
MS Level Requirement	None Level 1 Level 2 Level 3 Other
If other
Reflow Temp Requirement (°C)
Peak Temp
Any other special requirements?
Production Requirements
Expected Run Rate	Jan-Mar Apr-Jun Jul-Sep Oct-Dec
Expected Production Start Date
Any other special requirements?
Contact Information
*First Name
Last Name
*Email Address
Business Phone
*Company Name
*Address Line 1
Address Line 2
*City
Postal Code
State or Province
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If you are entering this request on behalf of the end customer, please supply the following:
Your Name
Your Email Address