German ● English Russian Chinese

Waiver of Reference Samples

Supplier address e-mail

Supplier

Item No.

Description

Reason

VDA 2 requirements - "Quality assurance for deliveries" / Section 7

Retention samples (Reference samples) from initial sampling must be kept by the supplier.
Retention periods see QD83 Section 1.20

When the waiver of reference samples is approved the supplier has no longer to store / file
the reference sample. The approval only applies to the component and not to the
documentation.

The above-mentioned supplier requests to be exempted from the submission of reference

samples.

Location Date Name and signature (supplier)

ZF hereby confirms that the aforementioned suppllier is released from the duty to store
reference samples of the aforementioned component (Item No.).

Location Date Approved: Name and signature (ZF)

QD83 - F3.3B - Waver of Reference Samples - Rev. 1.0 - March 2018 Page 1 of 1