Fillable Printable Blank Fax Cover Sheet
Fillable Printable Blank Fax Cover Sheet
Blank Fax Cover Sheet
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Cover sheet
Page
of
Production process and product approval report
DwSpA
submittal level:
Name of supplier
Works designation New item
Works code/DUNS code Product change (specification change)
Street or PO box Transfer of production
Postal Code, City Production process change
Production suspended for longer than 12 months
Tool change / correction
Name of customer
Outsourced parts change
Change of supplier
Works designation others
Works code/DUNS code Re-sampling
Street or PO box New sample
Postal Code, City
Other sample report
Enclosed / Inspected
01 Dimension check 09 EMC Test 17 Measurement and test
equipment list
02 Function check 10 Reliability tests 18 Measurement and test
equipment certificates
03 Material test 11 Design FMEA 19 EU safety data sheet
04 Haptics test 12 Design approval 20 Material data sheet / IMDS
05 Acoustics test 13 Process FMEA 21 Transport unit / packaging
06 Odors test 14 Process flowchart 22 Certificates
07 Visual test 15 Production control plan 23 Process acceptance
08 Surface test 16 Proof of process capability 24 others
Supplier / production plant: Customer:
Ident. no./DUNS code: Works code/DUNS code
Identification no.:
Works code/DUNS code
Report no.: Report no.:
Description: Description:
Item no.:
Index:
Drawing no.:
Index:
Typ no.: Index: Item no.:
Index:
Status/date Status/date
Delivery note no./date: Goods inwards no./date:
Delivery quantity: Call order no. / date:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Batch no.: Offloading point:
Sample weight: g
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Supplier confirmation:
Name of supplier
Page
Works designation of
Street or PO box
Postal Code, City
We hereby confirm that sampling
from part:
item-no.:
index:
has been carried out in accordance with VDA Volume 2, Chapter 4.
The IMDS data record has been created under IMDS ID No.:
Name: Comments:
Department:
Telephone:
Fax:
E-Mail:
Date: Signature
Decision over
Individual approvals
customer all
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Approved
Approved with
conditions, re-
sampling required
rejected,
RE sampling
neccessary
Deviation approval no.: Valid until: No. of units: Deadline for re-sampling
Return delivery note no. / -date:
Name: Comments:
Department:
Telephone:
Fax:
E-Mail
Date: Signature:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Tests result report
Page
Content of the PPA report of
Supplier: Name of supplier Customer: Name of customer
Production Plant: Works designation Plant: Works designation
Report no.: Report no.:
Description: Description:
Item no.:
Index:
Drawing no.:
Index:
Typ no.:
Index:
Item no.:
Index:
Status / date: Status/date:
Enclosure Status/date
01 Dimensional check
02 Function report
03 Material test
04 Haptics test
05 Acoustics test
06 Odours test
07 Visual test
08 Surface test
09 EMC test
10 Reliability test
11 Design FMEA
12 Design approval
13 Process FMEA
14 Process flowchart
15 Production control plan
16 Proof of process capability
17 Measurement and test equipment list
18 Measurement / test equipment certificates
19 EU safety data sheet
20 Material data sheet
21 Transport unit / packaging
22 Certificates
23 Process acceptance
24 others
Supplier comments:
Name:
Department:
Telephone:
Fax:
Nature, extent and identification
enclosures
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
E-Mail:
Date: Signature:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Tests result report
Process releated and other documents
Page
of
Supplier: Name of supplier Customer: Name of customer
Prod. Plant: Works designation Plant: Works designation
Report no.: Report no.:
Description: Description:
Item no.:
Index:
Drawing no.: Index:
Typ no.:
Index:
Item no.: Index:
Status / date: Status / date:
11 Design FMEA 18 Measurement and test equipment certificates
12 Design approval 19 EU safety data sheet
13 Process FMEA 20 Material data sheet
14 Process flowchart 21 Transport unit / packaging
15 Production control plan 22 Certificates
16 Proof of process capability 23 Process acceptance
17 Measurement and test equipment list
Supplier confirmation Customer decision :
Comments: Approved
Rejected, re-sampling required
Comments:
Name: Name:
Department: Department:
Telephon: Telephon:
Fax: Fax:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
E-Mail: E-Mail:
Date: Signature: Date: Signature:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Tests result report
Product releated test results
Page
of
Supplier: Name of supplier Customer: Name of customer
Prod. plant Works designation Plant: Works designation
1
Report no.: Report no.:
Description: Description:
Item no.:
Index:
Drawing no.:
Index:
Typ no.:
Index:
Item no.:
Index:
Status / date: Status / date:
01 Dimensional check 06 Odours test
02 Function check 07 Visual test
03 Material test 08 Surface test
04 Haptics test 09 EMC test
05 Acoustics test 10 Reliability test
Comments
Yes No
Supplier confirmation Customer decision :
Remarks: Approved
Rejected, re-sampling required
Comments:
Name: Name:
Department: Department:
Telephone: Telephone:
Fax: Fax.
Ref.
No.:
Requirements
Specifications
Actual values
Supplier
Specification
fulfilled
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
E-Mail: E-Mail
Date: Signature: Date: Signature:
MANN+HUMMEL GMBH
MHDE 000085 / Ä02 Stand 02/2009 KP-Q/Karl-Heinz Kälberer
Tests result report
Measuring methods Page
of
Supplier: Name of supplier Customer: Name of customer
Prod. plant: Works designation Plant: Works designation
Report no.: Report no.:
Description: Description:
Item no.: Index: Drawing no.: Index:
Typ no.: Index: Item no.: Index:
Status/date: Status/date:
No.: Description of measuring methods/sketches
Comment: Comment:
Name: Name:
Department: Department:
Telefon: Telefon:
Fax: Fax:
