Supplier information

    Supplier name:

    Contact:

    Supplier Part no:

    Brink Part no:

    Part name:

    Drawing Number:

    Descriptions of non-conformity


    Special characteristics affectedYesNo

    Expected effect of non-conformity for application in Brink product


    Proposal

    Use as it is
    Yes
    Explain why

    Repair/rework?Yes


    I hereby declare that the above information is true and correct

    I hereby declare that i am a legal representative of the company named above

    E-mail adres*

    Comments

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