55255-002 Rev - Korry · 2020. 10. 5. · 55255-002 Rev - Korry Electronics Co. 425-297-9700 11910 Beverly Park Road Everett, WA 98204 . As a production supplier of Korry Electronics

55255-002 Rev -

Korry Electronics Co. 425-297-9700 11910 Beverly Park Road www.korry.com Everett, WA 98204

As a production supplier of Korry Electronics Co., your company (“Company”) acknowledges that a thorough review of all requirements of the Supplier Quality Manual (D55255) has been completed by the appropriate individual(s).

D55255 revision reviewed: Your company agrees to the following statement (check only the statement that applies):

☐ Our Company complies with the requirements of the Supplier Quality Manual (D55255) without exception.

☐ Our Company complies with the requirements of the Supplier Quality Manual (D55255) with the exceptions listed below. List all section numbers from D55255 that your company takes exception.

Note: The Supplier Quality Manual Compliance Matrix (D55255-001) must be complete at time of submission.

Company Name:

Company Representative:

Representative Title:

Signature: Date:

NOTICE: This document only contains business process information. It does not contain technical data as defined in 15 CFR 772 or 22 CFR 120.10.

This document is not subject to U.S. export controls under the EAR or the ITAR.

D55255 revision reviewed: Company Name: Company Representative: Representative Title: Date: List of exceptions: Check Box1: OffCheck Box2: Off