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. Number:
Process Reference:

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 PROCESSES,
AND FUNCTIONAL TESTING
Sheet____ 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. 9. Customer 10. Certificate of

Name: Specificatio Supplier: Approval Conformance Number:
n Number: Verification:

(Yes/No/NA)

11. Functional Test 12. Acceptance Report Number:

Procedure Number:

13. Comment

14. 15. Date

Signature
 Sample AS/EN/SJAC9102B Form
FORM 3: CHARACTERISTIC ACCOUNTABILITY, VERIFICATION, AND CO

1. Part 2. Part Name

Number

Characteristic Accountability Inspection / Test R

5. Char 6. Reference 7. Characteristic 8. Upper Lower 9. Results
No. Location Designator Requirement Tolerance Tolerance

1 C4
2 A6
3 B6 2.25 0.03 -0.03

12. Signature
AC9102B Form
RIFICATION, AND COMPATIBILITY EVALUATION

Sheet 1 of 1

3. Serial Number: 4. FAIR Number:

Inspection / Test Results

10. Designed / 11. 14. Additional Data / Comments
Qualified Nonconforman
Tooling ce Number

vernier

13. Date