(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:___/___/______

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:___/___/______

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

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

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

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

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

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

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

page no. ____                                                 fqaempform.txt 12/05/99