Waiver Request Id No. (Filled in by Wencor Group) 1. Waiver Request (Filled in by Supplier)

Supplier Waiver Request

WAIVER REQUEST ID NO.

(FILLED IN BY WENCOR GROUP)

1. WAIVER REQUEST (FILLED IN BY SUPPLIER) DATE DIXIE AEROSPACE, WENCOR, WAIVER REQUEST FOR KITCO DEFENSE LLC LLC NAME OF COMPANY CITY MANUFACTURING ADDRESS STATE PURCHASE ORDER NO. PHONE NO. ZIP SUPPLIER UNIQUE NO. ***TYPE OF DISCREPANCY*** WENCOR GROUP PART NO. NONCONFORMANCE PART DESCRIPTION/NAME REQUEST FOR INFO./CHANGE DRAWING NO. ***WHEN DISCREPANCY DISCOVERED*** DRAWING REVISION NO. CONTRACT REVIEW CAGE CODE MADE TO BEFORE MANUFACTURING SUPPLIER REP. PRINTED NAME DURING MANUFACTURING SUPPLIER REP. TITLE AFTER MANUFACTURING DISCREPANT FEATURES (INCLUDE RED LINED DRAWING AND/OR PICTURES) DISCREPANT FEATURE NO. 1 2 3 QUANTITY AFFECTED TOTAL BATCH QUANTITY BATCH SERIAL NO.

SHOULD BE CONDITION

ACTUAL CONDITION

ROOT CAUSE

CORRECTIVE ACTION

INTERNAL CAR NO. 2. WENCOR GROUP ONLY BELOW ***APPLIES TO THIS LOT ONLY*** USE AS-IS SCRAP

OTHER COMMENTS (IF APPLICABLE)

SUPPLIER QUALITY ENGINEERING SIGNATURE & SIGNATURE & PRINTED PRINTED NAME NAME

MRB QE SIGNATURE & PRINTED PURCHASING SIGNATURE NAME & PRINTED NAME

WQAF-14-03-02 Page 1 of 1 DCR 625 Rev B 07/28/15