Part Submission Warrant

Part Name

Customer Part Number

Rev.
If applicable

Engineering Drawing
Change Level

Tool PO Number

Dated

Additional Engineering Changes

Dated

Shown on Drawing Number

Purchase Order No.

Checking Aid Number

Weight (kg)

Engineering Change Level

Dated

ORGANIZATION MANUFACTURING INFORMATION

SUBMISSION INFORMATION

Organization name and Code

Customer Name/Division

Street Address

Customer Contact

City

State

Note:

Zip

Application

Does this part contain any restricted or reportable substances?

Yes

No

Are plastic parts identified with appropriate ISO marking codes?

Yes

No

REASON FOR SUBMISSION (check at least one)

Initial submission

Change to Optional Construction or Material

Engineering Change(s)

Sub-Supplier or Material Source Change

Tooling: Transfer, Replacement, Refurbishment, or additional

Change in Part Processing

Correction of Discrepancy

Parts produced at Additional Location

Tooling inactive > than 1 year

Other - please specify below

SUBMISSION LEVEL (Check one)

Level 1 - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to customer.
Level 2 - Warrant with product samples and limited supporting data submitted to customer.
Level 3 - Warrant with product samples and complete supporting data submitted to customer.
Level 4 - Warrant and other requirements as defined by customer.
1

10 11 12 13 14 15 16 17 18 19

(check)

Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.
DECLARATION
I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer
drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular
production process. I also certify that documented evidence of such compliance is on file and available for review.
EXPLANATION/COMMENTS

List Molds / Cavities / Production Processes

Organization Authorized Signature

Date

Print Name

Phone No.

Title

Fax

e-mail

FOR CUSTOMER USE ONLY

PPAP Warrant Disposition:

Customer Signature

Approved
Rejected
Interim Approval

Comment:

Date

Print Name

Volvo PSW 4th Edition PPAP

Part Submission Warrant

1

Part Name

Customer Part Number

Rev.

If applicable
Engineering Drawing
Change Level

Tool PO Number

Dated

Additional Engineering Changes

Dated

Shown on Drawing Number

10

Checking Aid Number

Purchase Order No.

11

Engineering Change Level

ORGANIZATION MANUFACTURING INFORMATION

Weight (kg)

Dated

SUBMISSION INFORMATION
14

12
Organization name and Code

Customer Name/Division

13

15

Street Address

Customer Contact
16

City

State

Note:

Zip

Application

Does this part contain any restricted or reportable substances?

Yes

No

Yes

No

17
Are plastic parts identified with appropriate ISO marking codes?
REASON FOR SUBMISSION (check at least one)

18

Initial submission

Change to Optional Construction or Material

Engineering Change(s)

Sub-Supplier or Material Source Change

Tooling: Transfer, Replacement, Refurbishment, or additional

Change in Part Processing

Correction of Discrepancy

Parts produced at Additional Location

Tooling inactive > than 1 year

Other - please specify below

19

SUBMISSION LEVEL (Check one)

Level 1 - Warrant only (and for designated appearance items, an Appearance Approval Report) submitted to customer.
Level 2 - Warrant with product samples and limited supporting data submitted to customer.
Level 3 - Warrant with product samples and complete supporting data submitted to customer.
Level 4 - Warrant and other requirements as defined by customer.
1

10 11 12 13 14 15 16 17 18 19

(check)

Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location.
DECLARATION
I affirm that the samples represented by this warrant are representative of our parts and have been made to the applicable customer
drawings and specifications and are made from specified materials on regular production tooling with no operations other than the regular
production process. I also certify that documented evidence of such compliance is on file and available for review.
20

EXPLANATION/COMMENTS

21

List Molds / Cavities / Production Processes

22

Organization Authorized Signature

Print Name

Date

Phone No.

Title

Fax

e-mail

FOR CUSTOMER USE ONLY

PPAP Warrant Disposition:

Customer Signature
Print Name

Approved
Rejected
Interim Approval
Date

Comment:

Completion of the Part Submission Warrant

PART INFORMATION
1. Part Name: Engineering released finished end item part name. (See Volvo Part Version Report.)
2. Customer Part Number(s): Engineering released finished end item part number. (Volvo PVR number.)
3. Part Revision Level: if applicable. (Volvo PVR Version.)
4. Tool Purchase Order Number: if applicable.
5. Engineering Drawing Change Level & Approval Date: Show change level and date for submission. (Volvo drawing issue, see PVR
and drawing.)
6. Additional Engineering Changes: Include all authorized engineering change documents and approval dates not yet incorporated on the
drawing but which are incorporated in the part.
7. Shown on Drawing Number: The design record that specifies the customer part number being submitted. (Volvo drawing No, see PVR and
drawing.)
8. Purchase Order Number: Enter this number as found on the purchase order.
9. Part weight: Enter the actual weight in kilograms to four significant places.
10. Checking Aid No: Enter the checking aid number, if one is used for dimensional inspection.
11. Checking Aid's Engineering Change Level and Approval Date.
ORGANIZATION MANUFACTURING INFORMATION
12. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase order. (Supplier Name and Volvo
supplier No.)
13. Organization Manufacturing Address: Show the complete address of the location where the product was manufactured.
SUBMISSION INFORMATION
14. Customer Name/ Division: Show the corporate name and division or operations group. (Volvo purchasing company, e.g. Volvo 3P, Volvo
Powertrain, etc.)
15. Contact Name: Enter the name of your customer contact. (Volvo SQA and/or Volvo purchaser.)
16. Application: Enter the model year, vehicle name, or engine, transmission, etc.
17. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009,1)/ISO marking reporting.
REASON FOR SUBMISSION
18. Check the appropriate box. Add explanatory details in the "other" section.
REQUESTED SUBMISSION LEVEL
19. Identify the submission level requested by your customer. Check the submission items if a level 4 is requested.
If not otherwise agreed Volvo request level 4. The minimum required mandatory documents are:
6. Process FMEA;
7. Control Plan;
9. Dimensional Results including Marked Drawing;
10. Material, Performance Test Results;
13. Appearance Approval Report (if applicable);
17. Records of Compliance with Volvo Specific Requirements (Review of Technical Specification ,RTS). Mandatory for Volvo Powertrain.
18. Part Submission Warrant (PSW).
All other documents shall be submitted to Volvo upon request.
DECLARATION
20. Explanation/Comments: Provide any explanatory details on the submission results; additional information may be attached as
appropriate.
21. Enter the number or code that identifies the specific mold, cavity, and/or production process used to manufacture the sample parts.
22. The responsible supplier official, after verifying that the results show conformance to all customer requirements and that all required
documentation is available shall approve the declaration and provide Title, Phone Number, Email Address, and Fax Number.
FOR CUSTOMER USE ONLY
Leave blank

New 4th Edition PSW Completion Instruction Wording

Appendix A
Completion of the Part Submission Warrant
PART INFORMATION
1. Part Name: Engineering released finished end item part name. (See Volvo Part Version Report.)
2. Customer Part Number(s): Engineering released finished end item part number. (Volvo PVR number.)
3. Part Revision Level: if applicable. (Volvo PVR Version.)
4. Tool Purchase Order Number: if applicable.
5. Engineering Drawing Change Level & Approval Date: Show change level and date for submission. (Volvo
drawing issue, see PVR and drawing.)
6. Additional Engineering Changes: Include all authorized engineering change documents and approval dates
not yet incorporated on the drawing but which are incorporated in the part.
7. Shown on Drawing Number: The design record that specifies the customer part number being submitted.
(Volvo drawing No, see PVR and drawing.)
8. Purchase Order Number: Enter this number as found on the purchase order.
9. Part weight: Enter the actual weight in kilograms to four significant places.
10. Checking Aid No: Enter the checking aid number, if one is used for dimensional inspection.
11. Checking Aid's Engineering Change Level and Approval Date.
ORGANIZATION MANUFACTURING INFORMATION
12. Organization Name and Code: Show the code assigned to the manufacturing location on the purchase
order. (Supplier Name and Volvo supplier No.)
13. ORGANIZATION Manufacturing Address: Show the complete address of the location where the product
was manufactured.
SUBMISSION INFORMATION
14. Customer Name/ Division: Show the corporate name and division or operations group. (Volvo purchasing
company, e.g. Volvo 3P, Volvo Powertrain, etc.)
15. Contact Name: Enter the name of your customer contact. (Volvo SQA and/or Volvo purchaser.)
16. Application: Enter the model year, vehicle name, or engine, transmission, etc.
17. Check the appropriate box to indicate Substances of Concern (Volvo black list STD 1009,1)/ISO
marking reporting.
REASON FOR SUBMISSION
18. Check the appropriate box. Add explanatory details in the "other" section.
REQUESTED SUBMISSION LEVEL
19. Identify the submission level requested by your customer. Check the submission items if a level 4 is
requested.
If not otherwise agreed Volvo request level 4. The minimum required mandatory documents are:
6. Process FMEA;
7. Control Plan;
9. Dimensional Results including Marked Drawing;
10. Material, Performance Test Results;
13. Appearance Approval Report (if applicable);
17. Records of Compliance with Volvo Specific Requirements (RTS). Mandatory for Volvo Powertrain.
18. Part Submission Warrant (PSW).
All other documents shall be submitted to Volvo upon request.

DECLARATION
20. Explanation/Comments: Provide any explanatory details on the submission results; additional information
may be attached as appropriate.
21. Enter the number or code that identifies the specific mold, cavity, and/or production process used to
manufacture the sample parts.
22. The responsible supplier official, after verifying that the results show conformance to all customer
requirements and that all required documentation is available shall approve the declaration and provide Title,
Phone Number, Email Address, and Fax Number.
FOR CUSTOMER USE ONLY
Leave blank

APPEARANCE APPROVAL REPORT

PART
NUMBER

DRAWING
NUMBER

PART
NAME

BUYER
CODE

ORGANIZATION
NAME

APPLICATION
(VEHICLES)
E/C LEVEL

DATE

MANUFACTURING
LOCATION

REASON FOR
SUBMISSION

PART SUBMISSION WARRANT

PRE TEXTURE

SUPPLIER/VENDOR
CODE

SPECIAL SAMPLE
FIRST PRODUCTION SHIPMENT

OTHER

RE-SUBMISSION
ENGINEERING CHANGE

APPEARANCE EVALUATION
ORGANIZATION SOURCING AND TEXTURE INFORMATION

AUTHORIZED CUSTOMER
REPRESENTATIVE
SIGNATURE AND DATE

PRE-TEXTURE
EVALUATION
CORRECT AND
PROCEED
CORRECT AND
RESUBMIT
APPROVED TO
ETCH/TOOL/EDM

COLOR EVALUATION

COLOR
SUFFIX DL*

TRISTIMULUS DATA
Da*

Db*

DE*

CMC

MASTER
NUMBER

MASTER
DATE

MATERIAL MATERIAL
TYPE
SOURCE

HUE
RED

YEL

GRN

VALUE
BLU

LIGHT

DARK

CHROMA
GRAY

CLEAN

GLOSS
HIGH

LOW

METALLIC
BRILLIANCE
HIGH

COLOR
SHIPPING
SUFFIX

LOW

COMMENTS

PHONE
NO.

ORGANIZATION
SIGNATURE

March
2006

CFG-1002

DATE

AUTHORIZED CUSTOMER
REPRESENTATIVE SIGNATURE

DATE

PART
DISPOSITION

APPEARANCE APPROVAL REPORT

PART
NUMBER

DRAWING
NUMBER

PART
NAME

BUYER
CODE

ORGANIZATION
NAME
REASON FOR
SUBMISSION

MANUFACTURING
LOCATION

8
PART SUBMISSION WARRANT
PRE TEXTURE

11

APPLICATION
(VEHICLES)
E/C LEVEL

3
DATE

6/7

SUPPLIER/VENDOR
CODE

SPECIAL SAMPLE
FIRST PRODUCTION SHIPMENT

10

OTHER

RE-SUBMISSION
ENGINEERING CHANGE

APPEARANCE EVALUATION
12

ORGANIZATION SOURCING AND TEXTURE INFORMATION

PRE-TEXTURE
EVALUATION

13

AUTHORIZED CUSTOMER
REPRESENTATIVE
SIGNATURE AND DATE

CORRECT AND
PROCEED
CORRECT AND
RESUBMIT
APPROVED TO
ETCH/TOOL/EDM
21

COLOR EVALUATION

COLOR
SUFFIX DL*

16

15

14

TRISTIMULUS DATA
Da*

Db*

DE*

CMC

MASTER
NUMBER

17
MASTER
DATE

18

20

19

MATERIAL MATERIAL
TYPE
SOURCE

HUE
RED

YEL

GRN

VALUE
BLU

LIGHT

DARK

CHROMA
GRAY

CLEAN

GLOSS
HIGH

LOW

METALLIC
BRILLIANCE
HIGH

COLOR
SHIPPING
SUFFIX

LOW

COMMENTS
23

ORGANIZATION
SIGNATURE

March
2006

24

CFG-1002

PHONE NO.

DATE

AUTHORIZED CUSTOMER
REPRESENTATIVE SIGNATURE

25

DATE

22
PART
DISPOSITION

Appendix B
Report
1.
2.
3.
4.
5.
6./7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.

Completion of the Appearance Approval

Customer part number: Engineering released customer part number.

Drawing Number: Use the number of the drawing on which the part is shown if different from the
part number.
Application: Enter the model year(s) and vehicle or other program on which the part is used.
Part Name: Use the finished part name on the part drawing.
Buyer Code: Enter the code for specific buyer or part.
E/C Level & Date: Engineering change level and E/C date for this submission.
Organization Name: Organization responsible for submission (include supplier if available).
Manufacturing Location: Location where part was manufactured or assembled.
Supplier/Vendor Code: Customer-assigned code for organization location where the part was
manufactured or assembled.
Reason for submission: Check box(es) explaining the reason for this submission.
Organization Sourcing & Texture Information: List all first surface tools, graining source(s),
grain type(s), and grain and gloss masters used to check part.
Pre-Texture Evaluation: To be completed by authorized customer representative (not used by
GM).
Color Suffix: Use alphanumeric or numeric color identification
Tristimulus Data: List numerical (colorimeter) data of submission part as compared to the
customer-authorized master.
Master Number: Enter alphanumeric master identification (not used by Ford).
Master Date: Enter the date on which the master was approved.
Material Type: identify first surface finish and substrate (e.g;, paint/ABS).
Material Source: Identify first surface and substrate suppliers. Example: Redspot/Dow.
Color Evaluation, Hue, Value, Chroma, Gloss and Metallic Brilliance: Visual
assessment by customer
Color Shipping Suffix: Color part number suffix or color number.
Part Disposition: To be determined by customer (approved or rejected).
Comments: General comments by the organization or customer (optional).
Organization Signature, Phone No. & Date: Organization certification that the document
information is accurate and meets all requirements specified.
Authorized Customer Representative Signature & Date: Authorized Customer
Representative approval signature.
THE AREAS INSIDE THE BOLD LINES ARE FOR CUSTOMER USE ONLY.

Appendix C
Results

Production Part Approval,

Dimensional

Production Part Approval

Dimensional Test Results

ORGANIZATION:
SUPPLIER/VENDOR CODE:

PART NUMBER:
PART NAME:
DESIGN RECORD CHANGE LEVEL:
ENGINEERING CHANGE DOCUMENTS:

INSPECTION FACILITY:

ITEM

DIMENSION / SPECIFICATION

SPECIFICATION /
LIMITS

TEST
DATE

QTY.
TESTED

ORGANIZATION MEASUREMENT
RESULTS (DATA)

OK

NOT
OK

Blanket statements of conformance are unacceptable for any test results.

March
2006

CFG-1003

SIGNATURE

TITLE

DATE

Appendix D
Results

Production Part Approval,

Material Test

Production Part Approval

Material Test Results

ORGANIZATION:
SUPPLIER/VENDOR CODE:

PART NUMBER:
PART NAME:
DESIGN RECORD CHANGE LEVEL:
ENGINEERING CHANGE DOCUMENTS:

MATERIAL SUPPLIER:
*CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE:
*If source approval is req'd, include the supplier (Source) & Customer assigned code
MATERIAL SPEC. NO. / REV / DATE

SPECIFICATION /
LIMITS

TEST
DATE

QTY.
TESTED

NAME OF LABORATORY:
SUPPLIER TEST RESULTS (DATA)

OK

NOT
OK

Blanket statements of conformance are unacceptable for any test results.

March
2006

CFG-1004

SIGNATURE

TITLE

DATE

Appendix E
Results

Production Part Approval,

Performance Test

Production Part Approval

Performance Test Results

ORGANIZATION:
SUPPLIER/VENDOR CODE:

PART NUMBER:
PART NAME:
DESIGN RECORD CHANGE LEVEL:
ENGINEERING CHANGE DOCUMENTS:

NAME OFLABORATORY:
*CUSTOMER SPECIFIED SUPPLIER/VENDOR CODE:
*If source approval is req'd, include the supplier (Source) & Customer assigned code
TEST SPECIFICATION / REV / DATE

SPECIFICATION /
LIMITS

TEST
DATE

QTY.
TESTED

SUPPLIER TEST RESULTS (DATA) /

TEST CONDITIONS

OK

NOT
OK

Blanket statements of conformance are unacceptable for any test results.

March
2006

CFG-1005

SIGNATURE

TITLE

DATE