Part Name:Part Number:Date:Drawing Number:ECN:Weight:Checking Aid #:Revision Level:Purchase Order #:
Supplier Manufacturing Information Submission Information
Supplier Name:Dixie-Narco Supplier Code:Street Address:Dixie-Narco Buyer:City/State/Zip:Dixie-Narco SQE:
Reason For Submission: (Select All That Apply)
□ Initial Submission (New Part)□ Change of Optional Construction or Material□ New or Modified Tools, Dies, Molds, Etc…□ Engineering Change(s)□ Sub-Supplier or Material Source Change□ Refurbishment – Existing Tooling□ Correction of Discrepancy□ Change in Part Processing□ Other – Please Specify□ Tooling Inactive > Than 1 Year□ Parts Produced at Additional Location
Requested Submission Level (Check One)
Level 1 □Warrant, Appearance Approval Report (for designated appearance items only)Level 2 □Warrant, Appearance Approval Report (for designated appearance items only), Sample Parts, Design Records, Change Documents, Dimensional Results, Laboratory and Functional Test ResultsLevel 3 □At Customer Location – Warrant, A