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(The form below may be used to insure that your personnel ackowledge that they are informed about 'Fastener Quality Act Amendments Act of 1999'(FQA99).
(supplier company name) personnel certification of familiarity with P.L. 106-34, 'Fastener Quality Act Amendments Act of 1999'(FQA99).

My signature below affirms that I have read the full text of the above mentioned law. I have had any questions about the law fully explained to me.

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

name:_____________________signature:____________________ date:___/___/______

page no. ____      mina form fqa5 ver 12/05/99

You should revise the above form to suit your particular organization and situation.
Click here for a text (.txt) version of this form.
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