en 30 - PSW

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ANPQP v 3.

1
ANPQP - PART SUBMISSION WARRANT (PSW)

R / N Project: Safety Nissan Impt A Impt B Impt C OBD Doc. Ref. No./Ver.
Doc Rev. Date:
Regulation Renault 1 2
Doc. Origin Date:
Supplier Name: Supplier Code: E-mail:
Supplier Plant: Author: Tel:
Part Name: Control Plan Reference / Version:
Part No. & Issue Level: Control Plan Revision Date:
Design Note No. / DEVO: Average Weight:
Drawing No: R / N Plant:
First Part Delivery Date:

Initial Submission Process Change Tooling Change Details / Other:


Reason for
Design Change Sub-Supplier Change Tooling Refurbishment/Replacement
submission
Material Change Location Change Re-submission

Items attached to this Submission Warrant:


Control Plan Engineering Drawings Part Number Details
Process Flow Chart Component Supply Chain Chart Logistics and Packaging Data Sheet
Inspection Report (including IMDS ID) Gauge Specification / Approval Report Design / Process / Facility Change Request
Supplier Test Plan & Report Sub-components PSW or equivalent Full Volume Confirmation Audit Result
Process Capability Study Result Parts Capacity Submission Warrant
Appearance Approval Report Design Note Other

For each supporting document, indicate the issue level and date on an attached list.

Submission Acceptability Y
N
Dimensional Requirements OK The results meet all drawing and specification requirements: ● E
Appearance Requirements OK S
If NO, explanation required:
Material Requirements OK
Functional Requirements OK
Statistical Process Data OK
Component Marking OK
Full Volume Confirmation Audit Result OK

Declaration

I confirm that the samples covered by this documentation are representative of production parts and have been manufactured to the relevant
drawings and specifications with no off-standard operations in the production process. Any deviations from this declaration are as follows:

Name: Position:

Signature: Date:

RENAULT / NISSAN APPROVAL


Interim Approval
Approved Rejected
Approval

Name: Name:

Position: Position:

Signature: Signature:

Date: Date:

Note: Approval by Renault and / or Nissan shall not relieve the supplier in any way from its responsibilities

RENAULT / NISSAN COMMENT (mandatory in the case of Interim Approval or Rejection):

Copyright © Renault/NISSAN All Rights Reserved

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