Part Submission Warrant HARN-DRIVERS SEAT Part Name 181Q0-E8330 181Q0-E8330 Cust Part Number 181Q0-E8300 Shown on Drawing No Org Part Number PRODUCTION RELEASE Engineering Change Level Not Applicable Additional Engineering Changes Safety and/or Government Regulation Yes N/A Checking Aid No xxxxx Organization Name & Supplier/Vendor Code Customer Name/Division xxxx xxxxx Street Address Buyer/Buyer Code Region - Dated CUSTOMER SUBMITTAL INFORMATION xxxxxx1 Thaibinh City 0.800 KG Weight (kg) N/A Checking Aid Engineering Change Level ORGANIZATION MANUFACTURING INFORMATION - Dated PIA-0844 Purchase Order No No 02.08.15 Dated L42N 2015 Vietnam Country Postal Code Application MATERIALS REPORTING Has customer-required Substances of Concern information been reported? Yes n/a No Submitted by IMDS or other customer format: Yes Are polymeric parts identified with appropriate ISO marking codes? REASON FOR SUBMISSION No n/a (Check at least one) Initial Submission Change to Optional Construction or Material Engineering Change(s) Supplier or Material Source Change Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Change in Part Processing Tooling Inactive > than year Other - please specify below Parts Produced at Additional Location REQUESTED SUBMISSION LEVEL (Check one) Level - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to customer Level - Warrant with product samples and limited supporting data submitted to customer Level - Warrant with product samples and complete supporting data submitted to customer Level - Warrant and other requirements as defined by customer Level - Warrant with product samples and complete supporting data reviewed at organization's manufacturing location SUBMISSION RESULTS The results for dimensional measurements material and functional tests These results meet all drawing and specification requirements: Yes No N/A Mold / Cavity / Production Process appearance criteria statistical process package (If "NO" - Explanation Required) DECLARATION I hereby 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 4th Edition Requirements I also certify that documented evidence of such compliance is on file and available for review I have noted any deviations from the declaration below EXPLANATION/COMMENTS: Is each Customer Tool properly tagged and numbered? Yes No n/a Organization Authorized Signature Date Print Name Title Phone No QA Department manage +84-xxx3 Fax No hxxxx E-mail FOR CUSTOMER USE ONLY (IF APPLICABLE) Part Warrant Disposition: Approved Rejected Other Customer Signature Print Name Date Customer Tracking Number (optional) 08.Feb.2015 +84-3xxxx