零件提交保证书(PSW)带中文翻译批注模板

Part Name Cust. Part Numb er

Show

n on Drawi ng Numb er Suppli er Part Numb er

Engin

eering

Chang

e

Level Dated Additi

onal

Engin

eering

Chang

es Dated Safety

and/or

Gover nment Regul ation Purch ase Order No.

Check ing Aid Numb er Check

ing

Aid

Eng.

Chang

e

Level Dated

ORGA NIZAT

ION MANU FACT URIN G INFO RMAT ION CUST OME R SUBM ITTAL INFO RMAT ION

Organ ization Custo mer

Street Addre Buyer/ Buyer

City Regio

n

Postal

Code

Count

ry

Applic

ation

MATE RIALS REPO RTIN G Part Submission Warrant

Weight (kg) Yes No

Has

custo

mer-

requir

ed

Subst

ances

of

Conce

rn

inform

ation

been

report

ed?

Submi

tted

by

IMDS

or

other

custo

mer

format

:

Are

polym

eric

parts

identifi

ed

with

appro

priate

ISO

marki

ng

codes

?

REAS

ON

FOR

SUBM

ISSIO

N

(Chec

k at

least

one)

Initial submi ssion Chang e to Option al Constr uction or Materi al

Engin eering Chang e(s)Sub-

Suppli

er or

Materi

al

Sourc

e

Chang

e

Yes No

Yes No

n/a

n/a

Toolin g: Transf er, Repla ceme nt,

Refur bishm ent, or additio nal Chang e in Part Proce ssing

Corre ction of Discre pancy Parts produ ced at Additi onal Locati on

Toolin

g Inactiv e > than 1 year Other -please specif y

REQU

ESTE

D

SUBM

ISSIO

N

LEVE

L

(Chec

k one)

Level

1 -

Warra

nt only

(and

for

design

ated

appea

rance

items,

an

Appea

rance

Appro

val

Repor

t)

submit

ted to

custo

mer.

Level 2 -Warra nt with produ ct sampl es and limited suppo rting data submit ted to custo mer. Level 3 -Warra nt with produ ct sampl es and compl ete suppo rting data submit ted to custo mer.

Level 4 -Warra nt and other requir ement s as define d by custo mer.

Level 5 -Warra nt with produ ct sampl es and compl ete suppo rting data review ed at organi zation's

manuf acturi ng locatio n.

SUBM ISSIO N

RESU LTS The results for

These results meet all design record requir ement s:(If "NO" -Expla nation Requir ed)

Mold /Cavity /

Produ ction Proce ss

DECL ARATI ON

EXPL ANATI ON/C OMM ENTS:

I affirm that the samples represented by this warrant are representative of our parts,which were made by a process that meets all Production Part Approval Process Manual 4th Edition Requirements.I further affirm that these samples were produced at the production rate of 60PCS/1hours.I also certify that documented evidence of such compliance is on file and available for your review. I have noted any deviation from this declaration below.Yes NO

dimensional measurements material and functional tests appearance criteria statistical process package