Request for Quote – Flat Screen TV Lift with Corner Post Name* First Last Company*Email* Phone*FaxAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please select one of the following that best describes you:*Dealer / InstallerMarine - Yacht Owner, Ship Builder, Yacht DesignerArchitect - Designer / BuilderCabinet Maker / Furniture ManufacturerPrivate Consumer TV DimensionsTV Model and Number (i.e. Samsung UN55F8000)*Please specify units (in./mm, lbs./kgs, etc.)WidthDepthHeightWeightWill the TV be placed in an enclosure?*YesNoBracket Type (If TV will not be placed in an enclosure)*None, TV will be in an enclosure'Piano Hinge' Brackets'Z-Bar' BracketsWhich side will the Corner Post Swivel mount to the TV?*LEFTRIGHTHow many degrees do you want the Corner Post Swivel to turn?*90 degrees180 degreesController Action:*DUAL MOTION: (1. Lift 2. Swivel)SINGLE MOTION: (1. Lift then manually Swivel)Please select one of the following control options for the automatic swivel option (Dual Motion):*Automatic Dual Channel Full Swivel RF ControllerAuto Swivel with Touch Screen Controller: Programmed 12 VDC or Dry Contact ClosurePlease select one of the following control options for the automatic swivel option (Dual Motion):*Automatic Dual Channel Full Swivel RF ControllerAuto Swivel with Touch Screen Controller: Programmed 12 VDC or Dry Contact ClosurePlease select one of the following control options for the unit (Single Motion):*Rocker SwitchRadio Remote12 VDC External Trigger/Dry Contact signal to move lift UP or DOWNInfrared Transponder: TV "ON" & lift goes UP, TV "OFF" & lift goes DOWNVoltage Required*110VAC220 VAC, 230 VAC, or 240 VACOther (Please Specify below in Additional Notes)How did you hear about us?*InternetINCA Press ReleaseCEProReferralsPrinted Materials (ex. magazines, flyers, etc)EmailsPrevious CustomerOtherAdditional Notes (lift specification, location for installation, space restrictions, outdoor or yacht application, other special requirements, etc.)