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PSW

This document is a part submission warrant for a hot job part number. It provides information on engineering changes, safety regulations, supplier details, submission level requested, and test results. The supplier declares the samples meet all specifications and were produced at the required production rate. Space is provided for customer approval and comments.

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Kunal Karmakar
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© © All Rights Reserved
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368 views1 page

PSW

This document is a part submission warrant for a hot job part number. It provides information on engineering changes, safety regulations, supplier details, submission level requested, and test results. The supplier declares the samples meet all specifications and were produced at the required production rate. Space is provided for customer approval and comments.

Uploaded by

Kunal Karmakar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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PART SUBMISSION WARRANT ###

DaimlerChrysler ###
Part Certification ###
###
Part Name Part Number Part Nu
hot job #REF!
Tool Number

Safety and/or Government Regulation Engineering Drawing Change Level Dated


Yes No
#REF! #REF!
Additional Engineering Changes Dated

Shown on Drawing No. Purchase Order No. Weight


kg
Checking Aid No. Engineering Change Level Dated

SUPPLIER MANUFACTURING INFORMATION SUBMISSION INFORMATION


Dimensional Material / Functional Appearance
Supplier Name Supplier Code Customer Name / Division

Street Address Buyer / Buyer Code

City / State / Zip Application

Note: Does this part contain any restricted or reportable substances Yes No

Are plastics parts identified with appropriate ISO marking codes Yes No
REASON FOR SUBMISSION
Initial Submission Change to Optional Construction or Material
Engineering Change(s) Sub-Supplier or Material Source Change
Tooling: Transfer, Replacement, Refurbishment, or additional Change in Part Processing

.
Correction of Discrepancy Parts Produced at Additional Location
Tooling Inactive >than 1 Year Other - please specify

REQUESTED SUBMISSION LEVEL (Check one)


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 complete supporting data submitted to customer
Level 4 - Warrant and other requirements as defined by customer
Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.
SUBMISSION RESULTS
The results for dimensional measurements material and functional tests appearance criteria statistical process package
These results meet all drawing and specification requirements: Yes No (If "NO" - Explanation Required)
Mold/cavity/Production Process

DECLARATION
I hereby affirm that the samples represented by this warrant are representative of our parts, have been made to the applicable Production Approval Process Manual 3rd Edition
Requirements. I further warrant these samples were produced at the production rate of / 8 hours*.
I have noted any deviations from this declaration below.
EXPLANATION / COMMENTS:
*May not demonstrate the production Run-at- Rate capacity
Print Name Title Phone No. Fax

Supplier Authorized Signature

Part warrant disposition: Approved Rejected


...
FOR CUSTOMER USE ONLY
Part Functional Approval:
Date

Approved

Other Waived
Customer Name Customer Signature Date

The original copy of this document shall remain at suppliers location while the part is active (see Glossary) Optional: customer tracking number #

Filename: 432654282.xls / 01 PSW NAP 4.5-1 F-PSW


Compliance: June 1, 2001
Approval: December 14, 2000

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