Guaranteed Trial Request

This form is intended for authorized Xebec distributors and sales personnel. End users submitting an initial request are asked to complete a separate evaluation form to be reviewed/approved prior to the processing of a Guaranteed Trial. *Required fields are marked with an asterisk.

I am a(n)*

Distributor

Manufacturer's Rep

Zone Sales Director

Application Specialist

Industry*

What is the primary industry of the end user?

Medical

Aerospace

Firearms

Energy

Powertrain

General Production

Other

Requestor Name*

Requestor E-mail*

End User Name*

End User E-mail*

End User Street Address*

Address Line 2

End User City*

End User State*

End User Zip Code*

End User Country*

United States

Canada

Mexico

Outside North America

End User Telephone Number

Rep Agency

Select or enter value

Authorized Xebec Distributor*

Distributor Street Address

Distributor City

Distributor State*

Distributor Zip

Distributor Country

Select or enter value

Part Name / Number*

Please provide the part name/number. (Space provided for multiple entries, if applicable)

Part Material / Hardness*

What is the part material/hardness? (Space provided for multiple entries, if applicable)

Current Process / Tools Used*

What is the current process or tools being used?

Xebec EDP/Part Number Suggested for Trial*

Please list the EDP/Part Number(s) Suggested for Trial

Quantity Approved*

Please provide the quantity of each item suggested for trial. (Typical quantity approved for GTO is 1pc, each item.)

Annual Volume of Parts to be deburred*

(Space provided for multiple entries, if applicable)

Step or Tool Used Prior to Deburring*

What is the step or tool used prior to deburring? (Space provided for multiple entries, is applicable)

Finish Requirement*

What is the finish requirement? (Space provided for multiple entries, is applicable)

Machine Type

What is the machine type? (Space provided for multiple entries, is applicable)

Max Machine RPM*

Please provide the machine's max RPM. (Space provided for multiple entries, is applicable)

Coolant Capability*

Yes

No

Burr Size / Thickness*

What is the burr size/thickness? (Space provided for multiple entries, is applicable)

End User's Reason for Seeking Alternate Deburring Method

Please help us to understand the end user's reason(s) for seeking an alternative deburring method.

Crosshole Deburring

Is it a Crosshole Application*

Select or enter value

If you answered "Yes" to the question above, please complete the following:

Main Bore Diameter

Crosshole Diameter

Angle of Crosshole to Bore

Number of Crossholes

Additional Notes

Blueprints or Drawings

While not required, we recommend providing a blueprint marking the area on which you'd like to use Xebec deburring tools. This information will not be shared or distributed in any manner and will be kept strictly confidential.

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