PPAP_checklist

P PAPKIT_Steel Suppliers_F01 Rev. A (Oct_03)

D a n a C o r p.,P a r t S u b m i s s i o n Wa r r a n t

Part Name ______________________________________ Part Number _______________________________________ Government and/or Safety Regulation Engineering Drawing Change Level__________ Dated___________

Additional Engineering Changes _____________________________________________________________Dated___________ Shown on Drawing Number_____________________ Purchase Order Number______________________ Weight_________kg Checking Aid No.___________________________ Engineering Change Level_______________________ Dated___________

SUPPLIER MANUFACTURING INFORMATION SUBMISSION INFORMATION

__________________________________________________Materials/Functional

Supplier Name Supplier Code

__________________________________________________Customer Name/Division___________________________

Street Address

Buyer/Buyer Code________________________________

__________________________________________

City State Postal Code Application______________________________________

REASON FOR SUBMISSION

Engineering Change Sub-Supplier of Material Source Change

Tooling: Transfer, Replacement, Refurbishment, or additional

Parts Produced at Additional Location

Other – please specify____________________________________

REQUESTED SUBMISSION LEVEL (Check one)

Level 1 - A Dana—Warrant, Appearance Approval Report (for designated appearance items only)

Level 2 - A Dana—Warrant, Parts, Drawings, Inspection Results, Laboratory and Functional Results, Appearance Approval Report.

Level 3 - A Dana —Warrant, Parts, Drawings, Inspection Results, Laboratory Results, and Appearance Approval Report, Process Capability Results, Capability Study, Process Control Plan, Gage Study, FMEA.

Level 4- Per Level 3, but without parts.

Level 5- At Supplier Location – Warrant, Parts, Drawings, Inspection Results, Laboratory and Functional Results, Appearance Approval Report, Process Capability Results, Capability Study, Process Control Plan, Gage Study, FMEA.

S UBMISSION RESULTS

S ubmitting: dimensional measurements material & functional tests

T hese results meet all drawing and specification requirements:

D ECLARATION

I hereby affirm that the samples represented by this warrant are represented by this warrant are representative of our parts, have been made to the applicable Production Part Approval Process Manual 3rd Edition Requirements. I further warrant these samples were produced at the production rate of ______ / 8 hours.

T he product represented by this warrant conforms to all applicable government, End of Vehicle Life, and safety requirements for restriceted materials. Material Safety Data Sheets (MSDS) or equivalent are enclosed or have been previously submitted.

I have noted any deviations from this declaration below:

E XPLANATION / COMMENTS _______________________________________________________________________________________

P rint Name ___________________________________________ Title_______________________________ Phone No.___________________

S upplier Authorized Signature__________________________________________________________ Date: ____________________________

F OR DANA USE ONLY – Part Disposition: Approved Rejected Other

______________Representative_____________________Signature______________________Date___________

PPAPKIT_Steel Suppliers_F02 Rev. A (Oct_03)

D i m e n s i o n a l Te s t R e s u l ts SUPPLIER PART NUMBER

NAME/LOCATION OF INSPECTION FACILITY PART NAME

ITEM DIMENSION/

SPECIFICATION

SUPPLIER

MEASUREMENTS

OK NOT

OK

COMMENTS

(Dana use only)

Submitted by:

NAME TITLE SIGNATURE DATE PPAPKIT_Steel Suppliers_F03 Rev. A (Oct_03)

M a t e r i a l Te s t R e s u l ts SUPPLIER PART NUMBER

NAME/LOCATION OF LABORATORY PART NAME

TYPE OF TEST MATERIAL SPEC. NO./

DATE/

SPECIFICATION

SUPPLIER

TEST RESULTS

OK NOT

OK

COMMENTS

(Dana use only)

Submitted by:

NAME TITLE SIGNATURE DATE PPAPKIT_Steel Suppliers_F04 Rev. A (Oct_03)

P r o d u c t i o n P a r t Ap p r o v a l P r o c e s s—

P e r f o r m a n c e Te s t R e s u l t s SUPPLIER PART NUMBER

NAME/LOCATION OF LABORATORY PART NAME

REF. NO.REQUIREMENTS TEST

FREQ TEST

QTY.

SUPPLIER TEST

RESULTS AND

TEST CONDITIONS

OK NOT

OK

COMMENTS

(Dana use only)

Submitted by:

NAME TITLE SIGNATURE DATE P PAPKIT_Steel Suppliers_F05 Rev. A (Oct_03)