Supplier Repair Information

Supplier Information

L3Harris PO Number

PO Item Number

Note #

Entered By: Name

Entered By: Email Address

Supplier Part Number

Part Quantity

Supplier Serial Number(s)

Check if parts do not contain serial number(s)

Use "N/A" for parts without a serial number.

Under Warranty?

Yes No

Certificate of Compliance

Yes No

Return Type

Failure Information

Failure Verification

Failure Type

Please explain

Failure Description

Possible Cause

Acknowledgement

All repair reports require detailed descriptions of actions taken to bring repairs back to conformance.
Each specific comment or request made in the Failure Description of the PO must be addressed clearly and concisely without room for interpretation.
Failure to do so may result in the issuance of a SCAR.
* Acknowledgement of instructions required.

Repair Action

Repair Date

Email Copy

Email me a copy of this Repair Information

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