2. Vendor 3. Sheet 1 Of VIR No. 1. Vendor Name and Mailing Address 4. Purchase 5. Due 6. Schedule 7. Quantity Order No. Date Impact Y or N 8. Part Name 9. Part Number 10. Rev. NOR 11. Apparent Responsibility Vendor BAE Systems Other 12. Status of Part: In Process Not Started Completed Certified for this part Vendor # 13. Reason for Request: Nonconformance Change Interpretation Repair Weld Submittal 14. 15. 16. 17. 18. 19. 20. 21. Serial Item Sheet Zone Insp NC Discrepant Characteristic/Drawing Requirement Extent of Discrepancy/Actual Dimension Measured Number Qty. Qty. The Vendor accepts full responsibility for 22. Reported By 23. Email 24.Phone Number 25.Date the correctness of the information affecting the above parts. 26. Cause Of Nonconformance if applicable: 27. Corrective Action Taken if applicable: VENDOR: PLEASE DO NOT WRITE BELOW THIS LINE. 28. MRB Disposition Instructions: 29. Project/CCN Number 30. Contract/CLIN Number 31. QAMRB Date 32. Program Engineer Date 33. Purchasing Date 34. Customer Date
2. Vendor VIR No. 3. Sheet 1 Of 1. Vendor Name and Mailing Address 4. Purchase Order No. 5. Due Date 6. Schedule Impact Y or N 7. Quantity 8. Part Name 9. Part Number 10. Rev. NOR 11. Apparent Responsibility Vendor BAE Systems Other 12. Status of Part: In Process Not Started Completed Certified for this part Vendor # 13. Reason for Request: Nonconformance Change Interpretation Repair Weld Submittal 14. Item 15. Sheet 16. Zone 17. Insp Qty. 18. NC Qty. 19. Discrepant Characteristic/Drawing Requirement 20. Extent of Discrepancy/Actual Dimension Measured 21. Serial Number The Vendor accepts full responsibility for the correctness of the information affecting the above parts. 22. Reported By 23. Email 24.Phone Number 25.Date 26. Cause Of Nonconformance if applicable: 27. Corrective Action Taken if applicable: VENDOR: PLEASE DO NOT WRITE BELOW THIS LINE. 28. MRB Disposition Instructions: 29. Project/CCN Number 30. Contract/CLIN Number 31. QAMRB Date 32. Program Engineer Date 33. Purchasing Date 34. Customer Date