PSW 6
PSW 6
PSW 6
Part Name
Shown on Drawing No
Dated
Dated
Yes
No
Checking Aid No
Weight (Kg )
Dated
Street Address
City
Region
Postal Code
Application
Country
MATERIALS REPORTING
Has customer required Substances of Concern Information been reported ?
Yes
No
N/A
Yes
No
N/A
Engineering Change(s)
Correction of Discrepancy
Warrant with product samples and complete supporting data submitted to customer .
Yes
Dimensional measurements
Appearance critenia
No
( If NO - Explanation Required )
Production Process
DECLARATION
I affirm that the samples represented by this warrant are representative of our parts which were made by a process that meets all
Production Part Approval Process Manual 4 th Edition Requirements I further affirm that these samples were produced at the production
rate 200 pcs / 8 hours. I also certify that documented evidence of such compliance is on file and available for review. I have noted
any deviations from this declaration below .
EXPLANATION / COMMENTS :
Is each Customer Tool property tagged and numbered ?
OrganistionAuthorized Signature
Print Name
Yes
No
Date
Fax No
Phone No
FOR CUSTOMER USE ONLY ( IF APPLICABLE )
Approved
Rejected
Other
Date