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Sample Request

Use this form to request samples from Ohmite.

* indicates required field

Part # *

Ohm Value

Wattage

Tolerance

Estimated Annual Usage

Quantity of Samples

Application

First Name *

Last Name *

Title *

Company *

Email Address*

Phone Number *

Fax *

Address *

City *

State *

Zip *

Country *

How Can We Help You? *

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