Part Submission Warrant

Satyam Auto Components Ltd. PART SUBMISSION WARRANT Part Name BRACKET RR CUSHION R ASSY. Part Number PD/KWHF/R02/C00

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Satyam Auto Components Ltd.

PART SUBMISSION WARRANT Part Name

BRACKET RR CUSHION R ASSY.

Part Number

PD/KWHF/R02/C000

Safety and / or Government Regulation

Yes

No

Engineering Drawing Change Level

00

Dated

Additional Engineering Changes Shown on Drawing No.

Dated

PD/KWHF/R02/C000

Checking Aid No.

Purchase Order No.

Weight (Kg.)

Engineering Change Level

SUPPLIER MANUFACTURING INFORMATION

00

Dated

Dimensional

Materials/ functional

KOHARA MACHIWARA ROAD, VILL-MANNGARH

Customer Name/ Division

(Street Address)

Buyer/ Buyer Code PUNJAB

(City) Note :

8/12/2012

SUBMISSION INFORMATION

SATYAM AUTO COMPONENTS LTD. (Name & Code)

LUDHIANA

8/12/2012

Appearance

Satyam Auto Components Ltd. Haridwar 1052

Application

State

Pin

Does this part contain any restricted or reportable substances

Yes

No

Are plastic parts identified with appropriate ISO marking codes

Yes

No

REASON FOR SUBMISSION Initial Submission

Change to Optional Construction or Material

Engineering Change (s)

Sub-Supplier or Material Source Change

Tooling : Transfer, Replacement, Refurbishment or Additional

Change in Part Processing

Correction of Discrepancy

Parts Produced at Additional Location

Tooling Inactive > than 1 year

Other - Please Specify

REQUESTED SUBMISSION LEVEL (Check one) Level 1

- Warrant only (and for designated appearance items, an appearance approval report) submitted to customer.

Level 2

- Warrant with product samples and limited supported data submitted to customer.

Level 3

- Warrant with product samples and complete supporting data submitted to customer.

Level 4

- Warrant and other requirements as defined by customer.

Level 5

- Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.

SUBMISSION RESULTS The results for

dimensional measurements

materials & functional tests

These results meet all drawing and specification requirements: Meld / Cavity / Production Process

Yes

appearance criteria

statistical process package

No ( if "NO" - explanation required )

N.A.

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 warrant these samples were Produced at the production rate of 450pcs. / 8 hours. I have noted any deviations from this declaration below. EXPLANATION/ COMMENTS Print Name

Atul Singh

Title

Manager Q.A.

Phone No.

0161-2848399

Supplier Authorized Signature

Fax No.

0161-2848398

Dated

FOR CUSTOMER USE ONLY (IF APPLICABLE) Part Warrant Disposition :

Approved

Rejected

Part functional approval :

Other Customer Name

Approved Waived

Customer signature

Dated

Doc. No.- F(PE-P-02)-01

Issue-00/ 10.01.2012

Sheet- 01 of 01