QOF-722-07 Rev B Owner – Sales Date: 01/23/13 Page 1 of 1

Standard Product Variant Specification

1. Customer and Description

Customer Name	Customer No.

Contact Name	DSC Salesperson

Contact Phone

Contact Email	Base Product:

Description of changes:

Required Quantity and Schedule:

2. Change Detail (Attach additional sheets if needed)

Add	Del	Chg	Component / Description

3. Special Processing (Attach instructions or describe in space provided)

Conformal Coating – select type:	Acrylic	Silicone	Urethane

Hardwired jumpers (describe above)

Temperature test (describe above)	Other

4. Customer Approval (Indicates approval of specifications only)

Signature	Date

Printed Name	Title

5. DSC Use Only	Custom part no.:

Test Plan	Manufacturing Method	Prototypes	Production

Standard	Build to specification

Modified	Rework from standard product

Notes:

Approvals:	Sales	Eng	Mfg