Part Submission Warrant
Part Submission Warrant
Part Submission Warrant
Street Address Buyer / Buyer Code
City / Region / Postal Code / Country Application
Materials demoReporting
Has customer-required Substances of Concern information been reported? Yes No n/a
Submitted by IMDS or other customer format:
Ihre Firma GmbH – Kundenstrasse 1 – D-XXXXX
Are polymeric parts identified with appropriate ISO marking codes? Yes No n/a
Submission Results
The results for: dimensional measurements material and functional tests appearance criteria statistical process package
These results meet all drawing and specification requirements Yes No (if "No" - Explanation Required)
Mold / Cavity / Production Process:
demoDeclaration:
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 further affirm that these samples were produced at the production
rate of / 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.