KIT COMPONENT LIST FORM

							                                                             KIT COMPONENT LIST
Kit P/N:                                       Rev. Level:         Nomenclature:
EMBRAER PO:                                                              CofC or Invoice #:
I - DELIVERED COMPONENTS:
   Part number – P/N                 Nomenclature                     Qty.            Unit             Serial/ Batch number        Exp. Date




II - SHORTAGES:
           Part number – P/N                   Nomenclature                    Qty.      “Supplier” – ICM      EMBRAER - ICM     Will Ship Date




III – SUPPLEMENTARY INFORMATION:
Actual Weight:___________Kg                                  Specified Weight:___________Kg
QUALITY DEVIATIONS:
                  Deviation Number                             Affected Part Number                                    Remarks




Inspector:                                     Date:                                               Pag_______of_________



KIT COMPONENT LIST FORM                                                                                                                REVISION /