Sample AS9102B Form

FORM 1 - PART NUMBER ACCOUNTABILITY

Sheet____ of _____

1. Part Number: 2. Part Name: 3. Serial Number: 4. FAIR Number:

5. Part Revision Level: 6. Drawing Number: 7. Drawing Revision 8. Additional Changes:

Level:

9. Manufacturing 10. Organization Name: 11. Supplier Code: 12. Customer P.O.
Process Reference: Number:

13. Detail
Part: _____ 14. Full FAI: ___ Partial FAI: ___

Assembly _____ Baseline Part Number (including revision level):

FAI:
Reason for Partial FAI:
a) if above part number is a detail part only, go to Field 19
b) if above part number is an assembly, go to Field 15.

INDEX of part numbers or sub-assembly numbers required to make the assembly noted
15. Part Number: 16. Part Name: above. 17. Part Serial Number: 18. FAIR
Number:

1) Signature indicates that all characteristics are accounted for, meet drawing requirements or are properly
documented for disposition.
2) indicate if the FAI is complete.
_____ FAI Complete _____ FAI Not Complete
20. Date:
19. Prepared By:

22. Date:
21. Reviewed By:

24. Date:
23. Customer Approval Signature:
 Sample AS9102B Form
FORM 2: PRODUCT ACCOUNTABILITY - MATERIALS, SPECIAL PROCES

heet____ of _____

1. Part Number: 2. Part Name: 3. Serial Number: 4. FAIR

Number:
0 0 0 0
5. Material or Process 6. 7. Code: 8. Supplier: 9. Customer 10.
Name: Specificatio Approval Certificate
n Number: Verification: of
(Yes/No/NA) Conforman
ce Number:

11. Functional Test 12. Acceptance Report Number:

Procedure Number:

13. Comment

14. 15. Date

Signature
1/3/2020
 Sample AS9102B Form
FORM 3: CHARACTERISTIC ACCOUNTABILITY, VERIFICATION, AND COM

1. Part Number 0

Characteristic Accountability
5. Char No. 6. Reference Location 7. Characteristic Designator 8. Requirement Upper
Tolerance

Signature below indcates that all characteristics are accounted for, meet drawing requirements or are properly documented for
12. Signature

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ple AS9102B Form
ITY, VERIFICATION, AND COMPATIBILITY EVALUATION

Sheet____ of _____

2. Part Name 0 3. Serial Number 4. FAIR

Number
0 0

Inspection / Test Results

Lower 9. Results 10. Designed / 11. 14. Additional Data / Comments
Tolerance Qualified Tooling Nonconformance
Number

equirements or are properly documented for disposition.

13. Date 1/3/2020

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