ESON MULTIWIN DE MEXICO PPAP Approval Request

Tesla Part Number: Revision:

Tesla Part Description: Tesla Program(s):

Supplier Part Number (if applicable): Supplier Revision:

Engineering Change Order (ECO): Dated:

Purchase Order #: # Parts: Weight (kg):

SUPPLIER SUPPLIER MANUFACTURING LOCATION

Supplier/Vendor Code Supplier Company Name/Division

Address 1 Address 2

City Region/State Country Postal Code

Ye
MATERIALS REPORTING GADSL Declaration of Conformance (IMDS) No
sYe n/
Does this part contain any restricted or reportable substances? No
s
Ye a
n/
If a new revision, has the reportable material content changed? No
sYe a
Safety and/or Government Regulation No
s
Ye
Regional Certification / Partmark Required? No
sYe
Deviations/Comments? No
s
REQUIRED SUBMISSION REASON FOR SUBMISSION
PPAP Approval Form (and Appearance Approval Initial Submission
Reportpackage
PPAP if required)
with product samples, complete Design Change(s)
supporting data, and other requirements as Process/Tooling/Machine: Transfer, Replacement or
specified
ESON audit by at
ESON
manufacturing location (If Refurbishment
Sub-Supplier or-Material
PCR Attached
Source
requested by ESON QE) Change - PCR Attached
Other - please specify below:

SUBMISSION RESULTS
MEETS MEETS
YES NO N/A TESLA QE YES NO N/A TESLA QE
Supplier Quality Raw Material
Quality Assurance
Contacts Certifications
Sample Parts, Data,
Schedule Quality
and FAI
Part Evaluation
Readiness
Plan
Inspection PFS - No Critical
Rev: 00 Date: 6/18/2015 Checksheet
Standard
Process Quality
HVPT and Concerns
Capacity
Flow Chart Study
Appearance
Control Plan Standard and AAR
PFMEA Other:
Capability Results for Critical
Characteristics
Ye N
These results meet all drawing and specification requirements: (If "NO" - Explanation Required)
s o
Mold / Cavity / Production Process Represented:

Is each Customer Tool properly tagged and numbered according to ESON Multiwin Asset Management Requirements? Yes n/a
DECLARATION
I hereby affirm that the samples represented by this warrant are representative of our parts which were made by a process that meets all AIAG Production Part Approval Process
Manual 4th Edition Requirements including all ESON Multiwin additional requirements. I further affirm that these samples were produced at the production rate of
I also certify that documented evidence of such compliance is on file and available for review. I have noted any deviations from the declaration below.

EXPLANATION/COMMENTS:
AT MINIMUM, THE SUPPLIER IS EXPECTED TO MAINTAIN THE APPROVED LEVEL OF QUALITY

Supplier Authorized Signature: Date:

Print Name: Phone #:

Title: E-mail:

Part Warrant Disposition: FOR TESLA USE ONLY

Approv
ed
Interim PPAP Reason:
Approval
Rejecte
d

Tesla Quality Engineer Signature: Date:

Tesla Design Engineer Signature: Date:

Tesla Purchasing Signature: Date:

Routing: Supplier TESLA QE Supplier

Rev 04 CC: ESON
Design
CC: ESON Purchasing

BMS-0000163 rev 03