No.
Amdt No*
RRA/
0
Title
Sheet 1 of 2
* Note: Amendments are indicated by the text in bold italics
Materiel Acceptance and Release Form TX0206
To Supplier
Please arrange to address and despatch this shipment to
Purchase Order No.
Purchase Order Amdt No.
Customer Contract No(s)/Order No(s)
Supplier Internal Order No.
MOD Order No.
MOD 640/650
Materiel Description and Quantity:
Materiel Serial No(s)
Concession / Production Permit No(s) applicable (if “None” – State “None”)
Categories 1 and 2 to be sent with the Released Materiel
Category – 1 (Major)
Category – 2 (Minor)
Grade of Cleanliness
Category - 3
The above named Supplier and Rolls-Royce accept the materiel detailed and authorise despatch to the destination
stated herein. This acceptance and release is based on the Supplier’s certification that the materiel has been inspected
and tested and conforms with the requirements of the Purchase Order.
For THE SUPPLIER
Signed
Stamp or Print Name & Date
For ROLLS-ROYCE
Signed
Stamp & Date
Supplier Quality Engineer
CERTIFICATION OF CONFORMITY
This document when duly completed and signed constitutes the Rolls-Royce Certificate of Conformity that the materiel
supplied meets the customers’ requirements.
Circulation
Supplier Development & Quality Team
Buyer
Project Engineer
Configuration Management
PO Box 2000, Raynesway, Derby DE21 7XX Telephone: 01332 661461 Fax: 01332 622934
TX0206 Issue 13
Retention Category A
No.
RRA/
Amdt No*
0
Title
----___
Sheet 2 of 2
* Note: Amendments are indicated by the text in bold italics
______
______
______
______
______
_
Materiel Acceptance and Release Form TX0206
Continuation Sheet
For THE SUPPLIER
Signed
For ROLLS-ROYCE
Signed
Stamp
Supplier Quality Engineer
PO Box 2000, Raynesway, Derby DE21 7XX Telephone: 01332 661461 Fax: 01332 622934
TX0206 Issue 13
Retention Category A