Office: 1505 - 7th Street                    Mailing:  P.O. Box 906           Tel:  +1-309-764-9842        Fax:  +1-309-764-9848          Email:  info@lift-systems.com
East Moline, IL 61244                           Moline, IL 61266
CONTACT INFORMATION
FIRST NAME
LAST NAME
COMPANY NAME
EMAIL ADDRESS
PHONE
GENERAL INFORMATION
INTENDED USE AND
OTHER IMPORTANT
INFORMATION
QUANTITY REQUIRED
TYPE OF CYLINDER
 SINGLE ACTING
 DOUBLE ACTING
MOUNTING POSITION
 HORIZONTAL
 VERTICAL
SPECIAL MOUNTING REQUIREMENTS
TOTAL RETRACTED LENGTH
TOTAL EXTENDED LENGTH
OPERATING PRESSURE (PSI)
OPERATING FLUID
OPERATING TEMPERATURE RANGE
TOTAL AMOUNT OF PUSH/FORCE REQUIRED
CYCLE TIME  (    / MIN)
FLOW RATE (GPM)
REQUIREMENTS / CUSTOMER SPECIFICATIONS
BARREL:
 O.D.
 I.D.
ROD:
 DIAMETER
STROKE
BARREL END MOUNTING TYPE
ROD END MOUNTING TYPE
PORT LOCATION
EXTEND PORT SIZE
RETRACT PORT SIZE
QUESTIONS OR COMMENTS

Please fill out the form below and submit it to us.  Once submitted a Lift Systems
Cylinder Specialist will be in contact with you shortly.
LEADING the (R)EVOLUTION of
ALTERNATIVE LIFTING EQUIPMENT!