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

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

<p> Supplier Waiver Request</p><p>WAIVER REQUEST ID NO. </p><p>(FILLED IN BY WENCOR GROUP)</p><p>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.</p><p>SHOULD BE CONDITION</p><p>ACTUAL CONDITION</p><p>ROOT CAUSE</p><p>CORRECTIVE ACTION</p><p>INTERNAL CAR NO. 2. WENCOR GROUP ONLY BELOW ***APPLIES TO THIS LOT ONLY*** USE AS-IS SCRAP</p><p>OTHER COMMENTS (IF APPLICABLE)</p><p>SUPPLIER QUALITY ENGINEERING SIGNATURE & SIGNATURE & PRINTED PRINTED NAME NAME</p><p>MRB QE SIGNATURE & PRINTED PURCHASING SIGNATURE NAME & PRINTED NAME</p><p>WQAF-14-03-02 Page 1 of 1 DCR 625 Rev B 07/28/15</p>

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