Part Submission Warrant
PartNameHaldex Reg.Issued By:Issue
Customer
dIssue:
Part Number Engineering Drawing Change LevelRevision/Issue DatedTool PO NumberAdditional EngineeringChangesShown on Drawing No.Checking Aid No.ORGANIZATIONMANUFACTURINGINFORMATION(SUPPLIE OrganizationNameandCode(CR/ECR No)Dated Purchase Order No.Engineering Change level Weight (kg)Dated SUBMISSIONINFORMATION CustomerName/Division StreetAddress Buyer /SQE City State Zip (Postal Code) CountryNOTE:Doesthis1. ###No1. Are###YesSQEApplicationDoesthis###Yes1. ###No1. Thispart###Yes1. ###No1. plasti1. ###No1. Are###YesDoesthis###Yes1. ###No1. ######REASON FOR SUBMISSION (Check at least one) Initial Engin Toolin Correc Toolin######################## Change to Optional Construction or Material#### Supplier or Material Source Change#### Change in Part Processing#### Parts Produced at Additional Location#### Other - please specify belownew copy mouldREQUESTED SUBMISSION LEVEL (Default is Level 3) Level 1 - Warrant only ( and for designated appearance items, an Appearance Approval Report) submitted to customer. Level 2 - Warrant with product samples and limited supporting data submitted to customer. Level 3 - Warrant with product samples and completed supporting data submitted to customer. Level 4 - Warrant and other requirements as defined by customer.1(check)2345671011121314151617181. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. 1. Level 5 - Warrant with product samples and complete supporting data reviewed at organization's manufacturing locationDECLARATIONI affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer drawingsand specifications in accordance with PPAP Manual 4th Edition requirements, and are made from specified materials on regular production toolingwith no operations other than the regular production process at rate of90/1hours. I have noted any deviations of this declaration below.I also certify that documented evidence of such compliance is on file and available for review.ListNumbEXPLANAMolds:1Cavities:1Production Processes:1Authorized Supplier SignaturePrint NameTitle Date Phone No.E-mail Fax Customer Use OnlyPPAP Warrant Disposition:EXPLANAApproRejectDeviation No:InterimExp.Date:Authorized CustomerSignature:PrintDatePPAP REQUIREMENTS CHECKLISTPPAP Process RequirementsRequired?Yes1. Design Recordno2. Engineering Change DocumentsDescription of Requirement2D drawings, Engineering Specification, Technical Regulations, etc.Authorized engineering change documents for those changed not yetrecorded in the design record but incorporated in the product, part ortooling.Evidence of customer engineering approval (when specified bycustomer).DFMEA and its link to PFMEA, Process Flowchart and Control PlanEvidence - according to PFMEA ManualProcess Flow Diagram and its link to DFMEA, PFMEA and Control Planno3. Customer Engineering Approvalno4. Design Failure Mode and Effects Analysis(DFMEA)5. Process Flowchartnono6. Process Failure Mode and Effects Analysis(PFMEA)7. Control PlanPFMEA and its link to DFMEA, Process Flowchart and Control PlannoControl Plan that defines all methods used for process control and theirlink to DFMEA (if available), PFMEA and Process FlowchartMSA studies e.g., gage R&R, bias, linearity, stability, for all new ormodified gages, measurement and test equipment listed in the ControlPlan (per TS 16949:2009)Dimensional verifications with actual results all dimensions (exceptreference), characteristics, and specifications as noted on the designrecord and Control Plan with results indicating compliance. Requiredfor each unique production lines, molds, cavities, patterns, or diesMaterial Test results for all part/product materials when chemical,physical, or metallurgical requirements are specified on design recordor Control PlanPerformance or Functional Test when specified on design record orControl Planno8. Measurement System Analysis Studiesyes9. Dimensional Resultsno10. Material / Performance Test Resultsyes11. Initial Process StudyCapability study results for all Special Characteristics in the form of Cpkor Ppk-values. Acceptance requirements are >1.67 for short termstudies. Less then 1.33 Cpk will not be accepted and 100% inspectionmethods must be put in place.Internal and/or external Laboratory Scope indicating specific tests,evaluations, calibrations lab has ability and competency to perform, alist of equipment used to perform the above tests, and a list of methodsand standards to which it performs the above tests.Typically only applies to parts with color, grain, or surface appearancerequirements on design record.Sample parts as required by customer.no12. Qualified Laboratory Documentationno13. Appearance Approval Reportyes14. Sample Production Partno15. Master SampleRetained by Supplier for same period as the PPAP records. Mastersample includes samples for each cavity, mold, die, tool, or pattern.no16. Checking AidsIf requested by Customer: checking aids are fixture, variable or attributegages, models, templates, mylars specific to the product beingsubmitted.Defined customer requirements:Packing Instructionsno17. Customer-Specific Requirementsyes18. Part Submission Warrant (PSW)PSW signed by suppler verifying that all measurement and test resultsshow conformance with customer requirements and that all requireddocumentation is included in submission. A responsible supplierofficial shall approve the PSW.
