ROHS COMPLIANCE SURVEY 1) Steve Topel Title: Quality Manager Tel.: 920-648-6255 Steve.topel@hamlin.com e-mail: Does the part comply with RoHS Directive 2002/95/EC RoHS: Restriction of Hazardous Substances. This European directive states that no component can contain concentrations of the following materials greater than shown below: YES - Lead Pb (0.1%) - Mercury Hg (0.1%) NO - Cadmium Cd (0.01%) - Hexavalent Chromium (0.1%) - Polybrominated Biphenyls PBB (0.1%) - Polybrominated Diphenyl Ethers PBDE (0.1%) Date (DD MMM YYYY): Signature: (full signature required) Contact Person 10/10/05 (date code >0541) Steve Topel Phone E-mail Steve Topel 920-648-6255 steve.topel@hamlin.com 920-648-3001 Terry Radloff 920-648-6214 terry.radloff@hamlin.com 920-648-3001 Hamlin 612 East Lake Street * Lake Mills * WI * 53551 * USA Telephone: 920 648 3000 * Fax 920 648 3001 Email: sales.us@hamlin.com * Website: www.hamlin.com Or FAX Comments: Name: For DFE use only Submitted By Supplier Part #: _____/_____/_____ Hamlin Electronics L.P. Supplier Name: Date Cert. Emailed: Actuators NO Part Description Date: Rev.: Cert. #: N/A By: Hamlin Electronics L.P. Drawing #: Rev.: YES Hamlin Electronics L.P. Part #: 57070-000 57105-000 57125-000 57135-000 57140-000 57145-000 57150-000 Supplier submission received and approved? 57015-000 57020-000 57025-000 57030-000 57045-000 57050-000 57065-000