Get CFG-1001 2006-2024

I have noted any deviations from this declaration below. EXPLANATION/COMMENTS Is each Customer Tool Properly tagged and numbered Organization Authorized Signature Phone No. Title Fax No. E-mail FOR CUSTOMER USE ONLY IF APPLICABLE Part Warrant Disposition Customer Signature March CFG-1001 Approved Rejected Other Customer Tracking Number optional hours. Part Submission Warrant Part Name Cust. Part Number Shown on Drawing No* Org* Part Number Engineering Change Level Dated Additional Engineering Changes Yes Safety and/or Government Regulation Checking Aid No* No Purchase Order No* Weight kg Checking Aid Engineering Change Level ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION Supplier Name Supplier Code Customer Name/Division Buyer/Buyer Code Street Address Application City State Zip MATERIALS REPORTING YES NO n/a Has customer-required Substances of Concern information been reported Submitted by IMDS or other customer format Are polymeric parts identified with appropriate ISO marking codes REASON FOR SUBMISSION Initial Submission Change to Optional Construction or Material Sub-Supplier or Material Source Change Tooling Transfer Replacement Refurbishment or additional Change in Part Processing Correction of Discrepancy Part Produced at Additional Location Tooling Inactive 1 year Other - Please specify below REQUESTED SUBMISSION LEVEL Check one Level 1 - Warrant only and for designated appearance items an Appearance Approval Report submitted to customer. SUBMISSION RESULTS The results for dimensional measurements material and functional tests These results meet all drawing and specification requirements appearance criteria statistical process package If NO - Explanation Required Mold / Cavity / Production Process DECLARATION I hereby affirm that the samples represented by this warrant are representative of our parts have been made to the applicable Production Part Approval Process Manual 4th Edition Requirements. I further affirm that these samples were produced at the production rate of / I also certify that documented evidence of such compliance is on file and available for review. Part Submission Warrant Part Name Cust. Part Number Shown on Drawing No* Org* Part Number Engineering Change Level Dated Additional Engineering Changes Yes Safety and/or Government Regulation Checking Aid No* No Purchase Order No* Weight kg Checking Aid Engineering Change Level ORGANIZATION MANUFACTURING INFORMATION CUSTOMER SUBMITTAL INFORMATION Supplier Name Supplier Code Customer Name/Division Buyer/Buyer Code Street Address Application City State Zip MATERIALS REPORTING YES NO n/a Has customer-required Substances of Concern information been reported Submitted by IMDS or other customer format Are polymeric parts identified with appropriate ISO marking codes REASON FOR SUBMISSION Initial Submission Change to Optional Construction or Material Sub-Supplier or Material Source Change Tooling Transfer Replacement Refurbishment or additional Change in Part Processing Correction of Discrepancy Part Produced at Additional Location Tooling Inactive 1 year Other - Please specify below REQUESTED SUBMISSION LEVEL Check one Level 1 - Warrant only and for designated appearance items an Appearance Approval Report submitted to customer. SUBMISSION RESULTS The results for dimensional measurements material and functional tests These results meet all drawing and specification requirements appearance criteria statistical process package If NO - Explanation Required Mold / Cavity / Production Process DECLARATION I hereby affirm that the samples represented by this warrant are representative of our parts have been made to the applicable Production Part Approval Process Manual 4th Edition Requirements. .