GMSupplier PPAP WORKSHEET (GM 1411)PART NAME:PART #: EWO #/ E2 #: ECL:KG WT:INSP/SQE:ADD. SAMPLE:SUPPLIER NAME:SUPPLIER MFG DUNS CODE:GM 1411 EXPIRATION DATE:RESUBMISSION DATE:APPLICATION:SUBMISSION LEVEL:SAMPLE #:DATE:PPAP Activity Code #:Supplier/CustomerSection 1 Master Status Master Status: Select status being requested and complete section 2 & 3 as applicable (Shade or circle box)STR:NLab Status: Enter appropriate status for each lab (A=Approved, S=Saleable, N=Non-Saleable, NR=Not requested)DIM/STAT:FUN/DUR:APP/COL:MTL:IMDS:MTCH:Section 2 Supplier Performance and Validation Requirements (required unless otherwise specified in thecommodity-specific SOR (Item 1, 2, OR 3 must be checked)Customer1. Performance/Validation requirements met, signed copy of GM 3660 submitted in package2. Performance/Validation requirement items 1 & 5 on GM 3660 completed satisfactorily3. Performance requirements NOT fully met; status acceptable to move to a Saleable status ** GM Release Director AND Validation Director signature required; may vary per regionFor \"Approved Status\CG180, must be completed as indicated and a signed GM 3660 accepted by the GM Lead Engineer and GMValidation Engineer.Yes:Yes:Yes:N/A:No:Section 3 Action Plans - MUST be completed - Additional sheets attached as necessary ISSUES: List Lab and ALL Driver Codes thatapply with explanation for each:Comp. Date:ACTION PLANS to reach Approved PPAP and Owner for each:GP-12 PlanSupplierSUPPLIER (Authorized signature):NAME AND TITLE (Print):PHONE:FAX:PART SUBMISSION WARRANT MUST BE INCLUDED WITH CUSTOMER APPROVALS IN ORDER TO PROCESS YOUR REQUEST AND SEND TO THE PROCURING DIVISION.CUSTOMER APPROVALS:(as applicable)SIGNATURENAME (Print)PHONEDATEGM1411 PPAP Worksheet May 2009
Supplier Quality Engineer:Supplier Quality Director: Product Engineer (DRE):Validation Engineer:Release Director:Validation Director:LAB / Material Engineer:Appearance / Paint Engineer:Manufacturing Engineer:OTHER (Buyer, Assembly Plant, etc.):CustomerGM1411 PPAP Worksheet May 2009
