ATTACHMENT

Attachment 1 Warranty Cost Recovery Conditions for ADM vehicles

(Toyota-Brand, Daihatsu-Brand, Toyota for Japan Market)

Attachment 2 Debit Note

Summary of Warranty Claim

APPENDIX Warranty Request Forms

Warranty Cost Share Change Request

Appendix 1 Warranty Cost Share Proposal (WCSP)

Appendix 2 Warranty Data Analysis Sheet
Appendix 3 Problem Cause Investigation/ Analysis Report
Appendix 4 Share Rate Analysis Sheet
Appendix 5 Summary Share Rate Calculation Sheet

Warranty Cost Allocation Change Request

Appendix 6 Warranty Cost Allocation Change Request

Appendix 7 Attachment of WCAC
Appendix 8 Filling-out Guidance for WCAC

Warranty Claim Investigation Request

Appendix 9 Warranty Claim Investigation Request

Appendix 10 Attachment of WCIR
Appendix 11 Filling-out Guidance for WCIR

Part Recovery Request

Appendix 12 Part Recovery Request (PRR form)

Appendix 13 Filling-out Guidance for PRR
Attachment 1

Warranty Cost Recovery Condition for ADM vehicles

Efective from claim processed
on and after 26 Nov 2014
Toyota Brand
Hourly Labor Rate Part Reimbursement Rate (PRR)
No Dist. Code Country KM/Mile Warranty Period*
Currency Amount Base Price PRR
1 98073 Indonesia KM 3/100 $ 7.3 OE Price 1.65
2 97221 Thailand KM 3/100 $ 12 OE Price 1.65
3 98111 Philipines KM 3/100 $ 7.4 OE Price 1.65
4 98121 Malaysia KM 3/100 $ 11.8 OE Price 1.65
5 97181 Singapore KM 3/100 $ 58.5 OE Price 1.65
6 91041 USA KM 3/100 $ 97.55 OE Price 1.65
7 95011 Algeria KM 3/100 Euro 10.9 OE Price 1.65
8 95026 Angola KM 2/50 $ 27.3 OE Price 1.65
9 95051 Cameroon KM 2/50 ¥ 830 OE Price 1.65
10 95091 Benin KM 2/50 ¥ 460 OE Price 1.65
11 95106 Djibouti KM 2/50 $ 15 OE Price 1.65
12 95116 Ethiopia KM 2/50 ¥ 1010 OE Price 1.65
13 95174 Guinea KM 2/50 ¥ 1250 OE Price 1.65
14 95181 Cote D'ivore KM 2/50 ¥ 1450 OE Price 1.65
15 95196 Kenya KM 3/100 $ 18.6 OE Price 1.65
16 95241 Malawi KM 3/100 ZAR 156 OE Price 1.65
17 95251 Mauritius KM 3/100 $ 11.1 OE Price 1.65
18 95272 Mozambique KM 2/50 ZAR 42.4 OE Price 1.65
19 95282 Nigeria (TNL) KM 3/100 ¥ 1950 OE Price 1.65
20 95336 D.R. of Congo (Zaire) KM 2/50 ¥ 570 OE Price 1.65
21 95371 South Africa KM 3/100 Euro 33.5 OE Price 1.65
22 95441 Togo KM 2/50 ¥ 840 OE Price 1.65
23 95461 Tunisia KM 2/50 Euro 4.19 OE Price 1.65
24 95471 Egypt KM 3/100 $ 21.6 OE Price 1.65
25 95481 Burkina Paso KM 2/50 ¥ 440 OE Price 1.65
26 95561 Zimbabwe KM 3/100 $ 29.1 OE Price 1.65
27 96082 Jordan (CTA) KM 3/100 $ 18 OE Price 1.65
28 96092 Lebanon KM 3/100 $ 36.4 OE Price 1.65
29 96143 Syria KM 3/100 $ 18.2 OE Price 1.65
30 96196 Bangladesh KM 1/20 $ 7.15 OE Price 1.65
31 97038 Brunei KM 3/100 $ 34.7 OE Price 1.65
32 97062 Sri Lanka KM 2/50 ¥ 755 OE Price 1.65
33 97141 Nepal KM 1/20 $ 2 OE Price 1.65
34 97174 Pakistan KM 2/50 $ 3.8 OE Price 1.65
35 98246 Tahiti KM 3/100 A$ 44.69 OE Price 1.65
36 92092 Mexico KM 3/60 $ 20.07 (Metro Dir.) OE Price 1.65
37 92092 Mexico KM 3/60 $ 17.15 (Single Point Dir.) OE Price 1.65
* e.g. 3/100 = 3 years/100,000 KM

Toyota Brand - Japan Export (Town Ace/Lite Ace)

Hourly Labor Rate Part Reimbursement Rate (PRR)
No Dist. Code Country KM/Mile Warranty Period*
Currency Amount Base Price PRR
1 - Japan KM 3/60 ¥ 7200 Actual Claim Cost 0.96
* e.g. 3/60 = 3 years/60,000 KM
Warranty Cost Recovery Condition for ADM vehicles
Efective from claim processed on
and after 28 July 2014
Daihatsu Brand
Hourly Labor Rate Part Reimbursement Rate (PRR)
No Dist. Code Country KM/Mile Warranty Period*
Currency Amount Base Price PRR
38 11080 INDONESIA K 3/100 IDR 82500 OE Price 1.65
39 11160 SINGAPORE K 3/100 JPY 3200 OE Price 1.65
40 11320 BRUNEI K 3/100 JPY 1967 OE Price 1.65
41 13020 CHILE K 3/60 JPY 1913 OE Price 1.65
42 13030 PARAGUAY K 3/60 JPY 853 OE Price 1.65
43 13090 HONDURS K 3/60 USD 11.07 OE Price 1.65
44 13110 PERU K 3/100 JPY 2776 OE Price 1.65
45 13120 NICARAGUA K 2/50 USD 6.5 OE Price 1.65
46 13140 PANAMA K 3/100 JPY 2141 OE Price 1.65
47 13160 ELSALVADOR K 3/60 USD 19 OE Price 1.65
48 13190 PERU K 3/100 JPY 2776 OE Price 1.65
49 13220 DOMNICA K 3/60 JPY 1093 OE Price 1.65
50 13240 DOMNICA K 3/60 USD 11.04 OE Price 1.65
51 13260 HAITI K 2/50 USD 14 OE Price 1.65
52 13290 GUATEMALA K 3/100 USD 10.85 OE Price 1.65
53 13400 ST. LUCIA K 3/100 USD 15 OE Price 1.65
54 13480 JAMAICA K 3/100 USD 11.75 OE Price 1.65
55 13500 TRINIDAD K 3/100 USD 22.1 OE Price 1.65
56 13510 CURACAO K 3/100 USD 25 OE Price 1.65
57 13680 COSTA RICA K 3/100 USD 26.82 OE Price 1.65
58 13740 ANTIGUA M 0.5/6 JPY 383 OE Price 1.65
59 15040 KUWAIT K 3/100 JPY 1983 OE Price 1.65
60 15070 QATAR K 3/60 JPY 1640 OE Price 1.65
61 15080 U.A.E. K 3/100 USD 27.25 OE Price 1.65
62 15140 JORDAN K 0.5/10 JPY 164 OE Price 1.65
63 15180 S. ARABIA K 3/100 USD 34.74 OE Price 1.65
64 15190 OMAN K 3/100 USD 39.6 OE Price 1.65
65 15240 BAHRAIN K 3/100 JPY 656 OE Price 1.65
66 15350 SYRIA K 3/60 JPY 1487 OE Price 1.65
67 15370 SRI LANKA K 2/50 JPY 164 OE Price 1.65
68 15430 PAKISTAN K 1/20 JPY 270 OE Price 1.65
69 15440 NEPAL K 1/20 JPY 297 OE Price 1.65
70 15470 LEBANON K 3/100 JPY 820 OE Price 1.65
71 16040 EGYPT K 3/100 JPY 2052 OE Price 1.65
72 16080 SUDAN K 2/50 JPY 619 OE Price 1.65
73 16140 ALGERIA K 3/100 JPY 1159 OE Price 1.65
74 16340 SEYCHELLES K 2/50 JPY 1784 OE Price 1.65
75 16360 S. AFRICA K 3/60 JPY 3189 OE Price 1.65
76 16420 MOROCCO K 3/60 JPY 1373 OE Price 1.65
77 16740 GABON K 2/50 USD 5.04 OE Price 1.65
* e.g. 3/100 = 3 years/100,000 KM
Warranty Cost Recovery Condition for ADM vehicles
Efective from claim processed
Toyota Brand - Japan Export (Town Ace/Lite Ace) on and after 10 Dec 2014

Hourly Labor Rate Part Reimbursement Rate (PRR)

No Dist. Code Country KM/Mile Warranty Period*
Area Currency Amount Base Price PRR
Area A
1 - Japan KM 3/60 (Tokyo, Kanagawa, ¥ 7520 Actual Claim Cost 0.96
Aichi, Osaka)
Area B
(Sapporo, Saitama,
¥ 7260 Actual Claim Cost 0.96
Chiba, Shizuoka, Kyoto,
Hyogo, Fukuoka)

Area C
(Miyagi, Ibaragi,
Tochigi, Gunma,
Yamanashi, Toyama,
Ishikawa, Gifu, Mie, ¥ 7140 Actual Claim Cost 0.96
Shiga, Nara,
Wakayama, Okayama,
Hiroshima, Yamaguchi,
Nagasaki)

Area D
¥ 6900 Actual Claim Cost 0.96
(Others)
* e.g. 3/60 = 3 years/60,000 KM
Attachment 2
To: PT.ABCD Date.: 1-Jun-15
Jl.Mawar Melati 13
Jakarta Utara
INDONESIA

Attn: MR. ABCD

DIRECTOR

Summary Warranty Claim for Suppliers

The following claim have been processed at ADM.

Please process these claim and payment per the agreed procedures.

ADM Settlement Month 201503

Warranty Claim No. ADMWQS-19892-201503

Payment Term (Period) 25-May-15

Number Retroactive Retroactive

Amount Total Amount Currency
Claim (Amount) (Number Claim)

123,456,789 987 - 0 123,456,789 IDR

This claim will be compensated with our payment to you on 25th May, 2015

Signature:

Edward P Napitupulu
EC QA Division
Appendix 1

To: Mr. Edward P Napitupulu Ref. No. : WCSP-13-01-ABC

Executive Coordinator Date. : January 1, 2013
Quality Assurance Division From. : PT. ABC
PT. ASTRA DAIHATSU MOTOR Approved Checked Prepared

Warranty Cost Share Proposal

Please review this WCSP :
Current Share Rate Request Share Rate
NO Model Part Number Part Name
ADM DMC PT. ABC ADM DMC PT. ABC

Vehicle Production Period Proposed Settlement Month

Request Reason :

ADM Reply
Date :
We AGREE with your request From : ADM Quality Assurance Div.
We do not Agree with your request Approved Checked Prepared
Please consider our judgment

Summary New Share Rate (%)

ADM DMC PT. ABC

Reason / Comment:

This WCS applies to settlement month from

This WCS will be returned to the initial share rate from

Route : Supplier ---> ADM-QA ---> Supplier

Appendix 2

Warranty Data Analysis Sheet

1. Warranty data by received claim month

400 Domestic Export Claim Amount 250
Qty Case Total Amount
5 200
300 2333 IDR 1,522,519,985

Amount (Rp 1,000,000)

4 150
200 3 3
Case

1
312 100
3
230 1
100 2 198 183
205
3
3 1
136 0 5
50
105 0 101 2 11 3 4
93 88 94 3
67 2 5 59 50 48 51 3 61 52
29 26 41 28
2
0 7 0
2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2011 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012
01 02 03 04 05 06 07 08 09 10 11 12 01 02 03 04 05 06 07 08 09 10 11
Export 5 4 3 2 3 1 0 1 3 2 3 2 5 0 3 2 1 3 11 3 3 5 4
Domestic 312 230 136 93 198 105 67 183 205 29 88 7 26 59 101 50 94 41 48 51 28 61 52
Claim Amount 112 81.28 38.45 11.04 27.17 14.45 44.65 128.5 165.7 22.99 94.45 15.52 38.98 61.08 168.2 49.44 133 67.46 58.58 55.47 30.28 56.96 46.88

2. Vehicle type analysis 11/1-12 3. T Code analysis

200 Domestic Export

150
Qty.
2333 100

50

0
200

150

100

T2 Gra nd
12 14 15 16 17 18 19 23 40 41 43 50 54 61 71 73 74 83 84 88 99 55 57 60
50

T1 Tota l
0

1 11 3 1 1 114 38 21 1 190
( 4 ) ( 7 ) ( 13 ) ( 8 ) ( 9 ) (41)
2 1 1 2 4
( 2 ) ( 2 )
3 4 4

4 8 3 2 21 1 5 3 40 1 88 53 89 122 4 440
( 3 ) ( 2 ) ( 16 ) ( 2 ) (1 ) (37) (14) (32) (32) (139)
5 9 1 3 2 1 16

7 2 1 1 3 28 17 1 19 3 1 76
( 1 ) ( 1 ) (1 ) (13) ( 9 ) ( 1 ) ( 1 ) (27)
8 66 1 7 1 27 4 1 3 741 103 458 1 10 1 1424

SAMPLE DATA
(18) ( 7 ) ( 1 ) ( 1 ) ( 1 ) ( 1 ) (167) (53) (26) ( 3 ) (278)
17 5 2 1 1 26 2 5 1 1 44
(1 ) ( 4 ) (1 ) ( 6 )
59 1 1

64 2 2

72 1 1 29 1 32
( 1 ) ( 5 ) ( 6 )
73 4 2 18 4 1 1 1 31
( 1 ) (1 ) ( 2 )
83 1 1

87 1 10 1 12
(4 ) ( 4 )
91 7 1 8 2 2 2 2 1 1 6 4 1 37
( 1 ) ( 1 ) (1 ) ( 2 ) ( 5 )
97 1 1
( 1 ) ( 1 )
99 1 1 11 13

7B 2 2

1A 1 1

81 1 1 2

Grand 116 4 1 2 15 1 60 1 2 15 3 10 43 1 1051 235 1 595 7 142 25 1 1 1 2333

Domestic Export Tota l (28) ( 1 ) ( 9 ) ( 1 ) (17) ( 4 ) ( 3 ) ( 1 ) (234) (96) (67) ( 2 ) (47) ( 1 ) (511)

4. Line-off date analysis

150 Domestic Export
Countermeasure (C/M): Countermeasure (C/M):
(attach ECI if any) (attach ECI if any)
100
Case

50

0
200704

200706

200708

200710

200712

200802

200804

200806

200808

200810

200812

200902

200904

200906

200908

200910

200912

201002

201004

201006

201008

201010

201012

201102

201104

201106

201108

201110

201112

201202

201204

201206

201208
Appendix 3

Problem Cause Investigation/Analysis Report

Milleage Part Investigation Result

NO. Report Ref. Repair date TWC Cust. P/N No Chasis Delivery date T1 T2 Problem Cause Judgement / Reason
km Appearance Performance Overhaul Analysis Probable Cause
Appendix 4
Ref. No.:

Share Rate Analysis Sheet

Problem (Cause):
Refer No.: ECI No. :
RDDP No. :
Root Cause Countermeasure Implementation Date

Share Rate
Responsibility
Factor Category Affected Item Problem Proportion (%)
/ Reason ADM PT.ABC TMC/DMC

Plan

Parts
Design

Vehicle
- - -
(System)
Design

0.0%
Parts - - - - -
Evaluation

Vehicle
- - - - -
(System)

Preparation - - - - -
VEHICLE

Production - - - - -
Manufacturing

Inspection - - - - -
0%
Preparation - - - - -
PART

Production - - - - -

Inspection - - - - -

0% -

Note: 1) This sheet should be attached to "Warranty Cost Share Change Request".
2) Problem Investigation Report and Reference Document of above Share Rate Analysis should be attached.

-4-
Appendix 5
Ref. No.:

Summary Share Rate Calculation Sheet

Share Rate for Each Problem Share Rate

Return parts
Problem (Cause) Proportion
Number ADM DMC PT. ABC ADM DMC PT. ABC

Total 0 0.0% 0.0% 0.0% 0.0%

Note 1) Share rate should be judged according to Share Rate Guideline.

Note 2) After calculating total share rate, omit under decimals for Manuf. share rate.
Note 3) If defect mode is more than column, attach additional sheet.
Note 4) This sheet should be attached to " Warranty Cost Share Change Request".

-5-
Appendix 6
Warranty Cost Allocation Change Request Ref no. WCAC/Supplier Name/.../MM/YY

To : Mr. Edward P Napitupulu

EC QA Division
PT Astra Daihatsu Motor
Please investigation the following unclear warranty claim;
OFP TWC No. Claimant

Part No. for Judgment Part Name Model

Settlement period No. of parts claim Amount of warranty cost

Current cost Requestd cost Vehicle Line

Part source ID Allocation ID
allocation allocation off period

Detail description; Company name :

Approved Checked Prepared

Date Date Date

ADM Reply

To :
Agree with the request
Disagree with the request
Comment for disagree :

Company name :
Approved Checked Prepared

Date Date Date

Route : Requester (Local Supplier) --> ADM QA Dept --> Requester Local Supplier (All supported document is attached)
Appendix 7
PT. ASTRA DAIHATSU MOTOR
Quality Assurance Warranty Claim For Local Vendor
Vendor Code : 30475 Periode Date :
Vendor Name : PT. ABCD
Dst. Inv. : 001250

Before Cost Sharing After Cost Sharing

No. TWC No WMI VDS VIS Rep. Date Del. Date Cause Condition Remedy Dist. Code Dealer CodeDealer Name T1 T2 OFP Part Name Assy Date Mileage Part Rate Labor Rate P.Cat.
Part No.1 Qty 1 Part No.1 CostP art No.2 Qty 2 Part No.2 CostP art No.3 Qty 3 Part No.3 CostP art No.4 Qty 4 Part No.4 Cost Part Labor Sublet Total

Total Dst. Inv. : 0019397 - - - -

Grand Total - - - -
Appendix 8

Warranty Cost Allocation Change Request Ref no.

1 WCAC/Supplier Name/.../MM/YY

To : ADM Quality Assurance Div.

Please investigation the following unclear warranty claim;
OFP 2 3 TWC No. 4 Claimant

Part No. for Judgment 5 Part Name 6 7 Model

8 Settlement period 9 No. of parts claim 1Amount of warranty cost

Current cost Requestd cost Vehicle Line

Part source ID Allocation ID
allocation allocation off period
1 1 1 1 1

Detail description Company name :

1
Approved Checked Prepared

Date Date Date

FILLING OUT WARRANTY COST ALLOCATION CHANGE REQUEST

(warranty detail information refers to warranty data which sent to Local Suppliers by email everyday)
Input Field Description
1. Ref No. WCAC Reference No for WCAC
2. OFP Original Failed Part No (Refer from Warranty detail information)
3. TWC No. No. of TWC
4. Claimant Person or company who claim
5. Part No for judgment OEM part
6. Part Name Name of Part
7. Model Model of car ex: Avanza (484W), Xenia (D01N), Terios(D57G), etc
8. Settlement Period Settlement period from (yy/mm/dd) to(yy/mm/dd)
9. No. of past claim Quantity of past claim
10. Amount of Warranty Cost Total Amount all of claim
11. Part Source ID Part Source ID
1: Not Local Supplier Part (CKD)
2: Other Local supplier
12. Allocation ID 1: 100% ADM Responsibility
2: 100% other local supplier responsibility
13. Current Cost Allocation Current cost allocation ex: Supplier A

14. Requested Cost Allocation Requested Cost Allocation ex: Supplier B

15. Vehicle line of period Vehicle line off period : from (yy/mm/dd) to(yy/mm/dd)
16. Detail Description Detail reason of warranty claim's rejection
Appendix 9

Warranty Claim Investigation Request (WCIR) Ref. No. WCIR/Supplier Name/…./MM/YY

To : Mr. Edward P Napitupulu

EC QA Division
PT Astra Daihatsu Motor

Please study the following claim(s).

Settlement Month F. Dist OFP TWC No.

Model VIN L/O Date Other

Detailed description of the concern (attach further detailed information, if necessary)

Date
Requesting Company
Approved Checked Prepared

Due date for reply :

ADM REPLY

To:
Agree
Disagree
Reason / Comment

Date
Astra Daihatsu Motor, QA Div
Approved Checked Prepared

<Route> Local Supplier ADM-QA Local Supplier

Appendix 10

PT. ASTRA DAIHATSU MOTOR

Quality Assurance Warranty Claim For Local Vendor
Vendor Code : 30475 Periode Date :
Vendor Name : PT. ABCD
Dst. Inv. : 001250

Before Cost Sharing After Cost Sharing

No. TWC No WMI VDS VIS Rep. Date Del. Date Cause Condition Remedy Dist. Code Dealer CodeDealer Name T1 T2 OFP Part Name Assy Date Mileage Part Rate Labor Rate P.Cat.
Part No.1 Qty 1 Part No.1 CostP art No.2 Qty 2 Part No.2 CostP art No.3 Qty 3 Part No.3 CostP art No.4 Qty 4 Part No.4 Cost Part Labor Sublet Total

Total Dst. Inv. : 0019397 - - - -

Grand Total - - - -
Appendix 11

Warranty Claim Investigation Request (WCIR) Ref. No.1WCIR/Supplier Name/…./MM/YY

To : Mr. Edward P Napitupulu

EC QA Division
PT Astra Daihatsu Motor

Please study the following claim(s).

Settlement Month F. Dist OFP TWC No.

2 3 4 5
Model VIN L/O Date Other
6 7 8 9
Detailed description of the concern (attach further detailed information, if necessary)

Date
Requesting Company
Approved Checked Prepared

Due date for reply : 1

FILLING OUT WARRANTY COST ALLOCATION CHANGE REQUEST

(warranty detail information refers to warranty data which sent to Local Suppliers by email everyday)
Input Field Description
1. Ref No Reference No for WCAC
2. Settlement Month settlement period of the claim
3. F.Dist distributor code information
4. OFP Original Failed Part (claimed parts)
5. TWC No TWC No of the claim
6. Model Model of car ex: Avanza (484W), Xenia (D01N), Terios(D57G), etc
7. VIN Vehicle Identification No (frame no of the claimed unit)
8. LO Date Line Off date (the date when the car is fully assembled)
9. Others Other information
10. Detail desc of the concernDetail reason/explanation of the request (charge back request)
11. Due date for reply target for the request to be replied
Appendix 12
Format 1 PART RECOVERY REQUEST REGULAR
Version Nov'10
(This PRR form can be used for one problem/model/country only)

EDWARD P NAPITUPULU HEAD OF QA DIVISION PRR No : Issue Date : Covered Period:

Att:

RAHMAT SANTOSA STAF Company/Dept. :

Fwd:
Person's Name :
ALIF CHOLISANA HEAD SECTION Position :
cc:
IKE PROBOWATI STAF Fax No. : (Signature)

WE REQUEST THE RETURN OF FOLLOWING PARTS / UNITS TO US TO FACILITATE OUR INVESTIGATIONS.

WE ALSO AGREE TO REIMBURSE ALL INCIDENTAL COST ACCRUED WITHIN PRR DURATION.

REQUEST DETAIL
REQUEST TYPE [ ] Additional FTR/CRS Parts Request [ ] Non FTR/CRS Parts Request

REFERENCE [ ] CRS No: [ ] FTR No: [ ] TWC No:

REQUESTED COUNTRY
SUBJECT T1 = T2 =

VEHICLE MODEL NAME Avanza

Parts Number Parts Name Quantity

RECOVERY PARTS INFO (*)

Comment & Purpose

SOURCE [ ] Claim Parts Stored [ ] New Customer Complain

SHIPPING METHOD [ ] Air [ ] Sea [ ] Land

Courier Service Account : o DHL o FEDEX o Others _________________________

Company/Dept. :

Person's Name :

Position :
DESTINATION ADDRESS
Address :

Address (continue) :

Phone & Facsimile :

(*) Please attach additional information if necessary (NOTE: SHIP ON FREIGHT COLLECT BASIS)
REPLY DETAIL (TO BE COMPLETED BY PRR RECEIVER)

PRR RECEIVING DATE

[ ] Parts Available and will be sent on :

PARTS STATUS [ ] Parts scrapped already with the reason :

[ ] Parts are not available and waiting new customer complain (Signature)
Appendix 13
Format 1 PART RECOVERY REQUEST REGULAR
Version Nov'05
(This PRR form can be used for one problem/model/country only)

PRR No : Issue Date : Covered Period:

Att: 01
02 03 04
Company/Dept. :
Fwrd:
Person's Name :
05
Position :
cc:
Fax No. : (Signature)

WE REQUEST THE RETURN OF FOLLOWING PARTS / UNITS TO US TO FACILITATE OUR INVESTIGATIONS.

WE ALSO AGREE TO REIMBURSE ALL INCIDENTAL COST ACCRUED WITHIN PRR DURATION.

REQUEST DETAIL
REQUEST TYPE 06 [ ] Additional FTR/CRS Parts Request [ ] Non FTR/CRS Parts Request

REFERENCE 07 [ ] CRS No: [ ] FTR No: [ ] TWC No:

REQUESTED COUNTRY 08
SUBJECT 09
VEHICLE MODEL NAME 10
Parts Number Parts Name Quantity

11

RECOVERY PARTS INFO (*)

SOURCE 12 [ ] Claim Parts Stored [ ] New Customer Complain

SHIPPING METHOD 14 [ ] Air [ ] Sea [ ] Land

Company/Dept. :

Person's Name :
15
Position :
DESTINATION ADDRESS
Address :

Address (continue) :

Phone & Facsimile :

(*) Please attach additional information if necessary (NOTE: SHIP ON FREIGHT COLLECT BASIS)

REPLY DETAIL (TO BE COMPLETED BY PRR RECEIVER)

PRR RECEIVING DATE 19
[ ] Parts Available and will be sent on :

PARTS STATUS 20 [ ] Parts scrapped already with the reason :

[ ] Parts are not available and waiting new customer complain (Signature)

PRR Guidance - Page 1 / 6

PRR EXPLANATION OF ITEMS TO BE FILLED IN BY REQUESTER

01 Fill in the attention name, position, company-department, and fax number

Note: 'Fwrd' column will be completed by TMAP-CQE (only for PRR-REGULAR type)

02 Fill in the PRR number as below requirement:

PRR / ___ / ___ / __ / __
Serial Number (001 ~ 999)
Company Initial … e.g. TMT
Issue Month (01 ~ 12) … e.g. 01 for January
Issue Year (05 ~ 99) … e.g. 05 for 2005
e.g. PRR No: PRR/012/TMMIN/06/05

03 Self explanatory, e.g. 01 JUNE 2005

04 Self explanatory, e.g. 01 SEP 2005 or June-Sep '05

05 Fill in the requester name, position, company-department, fax number and authorizing signature

06 Self explanatory (only for PRR-REGULAR type)

07 Self explanatory

08 Self explanatory

09 Fill in the technical problem subject as mentioned on FTR/CRS

10 Self explanatory, e.g. model name: COROLLA

Note: more information for PRR-SPECIAL type, e.g. model name: COROLLA, model code: 186W
VDS: 53ZEC2, Q'ty : 5 units

11 Self explanatory, e.g. parts number : 43512-12620, parts name : Disc Rotor, Q'ty : 10 pcs
Note: more information for PRR-SPECIAL type, e.g. P/N : 43512-12620, Disc Rotor, 10 pcs, Q'ty/vehicle : 2 pcs

12 Self explanatory

13 Only for PRR-SPECIAL type, If necessary, attach additional information request

(sample #1 and sample #2 for reference)

14 Self explanatory

15 Fill in the destination attention name, position, company-department, fax number and authorizing signature

16 Only for PRR-SPECIAL type, If requester prepare the replacement parts, please fill in the estimate supply date

17 Self explanatory (only for PRR-SPECIAL type)

18 Refer to 'Special Operation Number Assignment For PRR' (only for PRR-SPECIAL type)

19 Self explanatory (only for PRR-REGULAR type)

20 Self explanatory (only for PRR-REGULAR type)