Phase 1

Phase 2

Phase 3

PPAP Submission Warrant Status

Cust. Part Number Organization Part Number Date Date

PART INFORMATION Part Name Shown on Drawing Number Engineering Change Level Additional Engineering Changes Optional Tracking Number Safety and/or Government Regulation Checking Aid Number Yes No Purchase Order No. Weight (kg) Dated

Checking Aid Change Level

ORGANIZATION MANUFACTURING INFORMATION Organization Name and Supplier Code Street Address Customer Name/Division Buyer/Buyer Code

City

State/County/Province

Zip

Country

Application

REASON FOR SUBMISSION Initial submission Engineering Change(s) Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Tooling Inactive > than 1 year REQUESTED 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. Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. DECLARATION and SUBMISSION RESULTS I affirm that the samples represented by this warrant are representative of our parts which were made by a process which meets all current edition Production Part Approval Process Manual requirements including all Ford-specific requirements. I further affirm that these samples were produced at the production rate of ________ / hours using production streams. I also certify that documented evidence of such compliance is on file and is available for review. I have noted any exceptions from this declaration below. EXPLANATION/COMMENTS Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other - please specify below

List Molds / Cavities / Production Processes:

(Attach a separate page if additional space is necessary)

Supplier Authorized Signature Print Name Title Phone No. Email Fax

Date

FOR FORD USE ONLY

PPAP Phased PPAP Warrant Status: Customer Signature Print Name
.

Interim Status (to be completed by Supplier)

a/
.

Non-PPAP Rejected Date

Approved

Interim Accepted
.

Interim Submission: Engineering

.

Authorization: Description:
(Incomplete PPAP Requirements)

Alert, Temp. PCM, TPD Number

.

a/ Non-PPAP indicates the part does not satisfy one or more PPAP requirements and is considered incomplete until all PPAP requirements are satisfied.
Ford GPPSS1 December 2004

The original copy of this document shall remain at the supplier's location while the part is active

Letter Format

Phase 1

Phase 2

Phase 3

PPAP Submission Warrant Status

Cust. Part Number Organization Part Number Date Date

PART INFORMATION Part Name Shown on Drawing Number Engineering Change Level Additional Engineering Changes Optional Tracking Number Safety and/or Government Regulation Checking Aid Number

Yes

No

Purchase Order No.

Weight (kg) Dated

Checking Aid Change Level

ORGANIZATION MANUFACTURING INFORMATION

Organization Name and Supplier Code Street Address

Customer Name/Division Buyer/Buyer Code

City

State/County/Province

Zip

Country

Application

REASON FOR SUBMISSION Initial submission Engineering Change(s) Tooling: Transfer, Replacement, Refurbishment, or additional Correction of Discrepancy Tooling Inactive > than 1 year REQUESTED 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. Level 5 - Warrant with product samples and complete supporting data reviewed at supplier's manufacturing location. DECLARATION and SUBMISSION RESULTS I affirm that the samples represented by this warrant are representative of our parts which were made by a process which meets all current edition Production Part Approval Process Manual requirements including all Ford-specific requirements. I further affirm that these samples were produced at the production rate of ________ / hours using production streams. I also certify that Change to Optional Construction or Material Sub-Supplier or Material Source Change Change in Part Processing Parts produced at Additional Location Other - please specify below

documented evidence of such compliance is on file and is available for review. I have noted any exceptions from this declaration below. EXPLANATION/COMMENTS

List Molds / Cavities / Production Processes:

(Attach a separate page if additional space is necessary)

Supplier Authorized Signature Print Name Title Phone No. Email Fax

Date

FOR FORD USE ONLY

PPAP Phased PPAP Warrant Status: Customer Signature Print Name
.

Interim Status (to be completed by Supplier)

a/
.

Non-PPAP Rejected Date

Approved

Interim Accepted
.

Interim Submission: Engineering

.

Authorization: Description:
(Incomplete PPAP Requirements)

Alert, Temp. PCM, TPD Number

.

a/ Non-PPAP indicates the part does not satisfy one or more PPAP requirements and is considered incomplete until all PPAP requirements are satisfied.
Ford GPPSS1 December 2004

The original copy of this document shall remain at the supplier's location while the part is active

A4 Format GPP Submission Status_Final Dec 2004.xls