Engineering Change Form Sample by bub68359

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Engineering Change Form Sample document sample

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									Supplier Notices or Request for Change
If possible, send this form and any supporting documentation in electronic format through email. Do not write protect this
form upon return. The results of this request will be sent through an e-mail notification whenever possible.
                                                                                               Date: ___________________________________
SUPPLIER                                                                          Notices of Change        Request for Change
Supplier Name

Supplier Documentation Identification ____________
Honeywell Part/Material Number Revision and Description



Honeywell Drawing Number and Revision




Change:      Design    Composition        Processing / Manufacturing      Description      End of Life     Other
Description of Change:

End Usage:



Effect of Change:


Effective Date / Time to incorporate change after approval

Will this notice impact shipping schedule?
    Yes        No                                                 Name and Title: _____________________________________

Honeywell Action
Notice of Change:
Last Time Buy             Life Time Buy       Obsolete Product         Other
End of Life Date:
Authorized by & Date                                              To Be Coordinated by
Request for Change:                                                 Sample of changed component required
Approved *         Yes      No     Rejected         Yes     No        Yes    No
Other              Yes      No
Detail of Action Taken:




Name & Title _______________________ Date __________
* This approval is granted upon the understanding that it is advisory in nature and in no manner changes the Seller's original
responsibility for insuring that all characteristics, designated in the applicable engineering specifications and/or inherent in samples
as originally tested and approved, are maintained. Seller accepts full responsibility for the changes or types of changes listed above;
and should such changes result in less satisfactory performance than experienced with the originally approved item, Seller will fully
reimburse the Buyer for all expenses incurred to correct the deficiency.




                       Instruction for Completing the Supplier Notices or Request for Change

Supplier Section:
    Control Products                                                                                            Uncontrolled Document
Notice of Change – Changes which Honeywell has no control over such as electronic parts manufacturing / test location changes or
obsolescence.

Request for Change – Changes which Honeywell can approve or decline based of our print requirements such as changes in
dimensions or tolerances.

Supplier Name – The name, address and contact person of supplier.

Honeywell Part / Material Number Revision and Description – Part or material affected by the change

Honeywell Drawing Number and Revision - Drawing numbers for part or material affected by change.

Change Type – Mark appropriate box.

Description of Change – Describe change or changes.

End Usage – Products or Sub-assemblies that use the affected parts

Effects of Change – What effects will the change have on the final part or product.

Effective Date / Time to implement change after approval – When will the notice take effect or how long to implement the change.

Honeywell Action Section:
Notice of Change:

Last Time Buy – Parts will be purchased to cover a defined period time or units. When the time or units is complete alternative actions
will be taken such as redesign or obsolesce of the parts and products. Authorization for this action is required.

LifeTime Buy - Parts will be purchased to cover the life of the product. When all units have been sold the products will be obsoleted.
Authorization for this action is required.

Obsolete Product – The affected parts and or products will be obsoleted.

End of Life Date – Estimate date to end of product life

Authorized by – Document who has authorized the purchase of parts or products

To Be Coordinated by – Person assigned to complete all tasks associated with Notice Action to be assigned by the authorizing
individual

Request for Change:
Approved – Yes, The requested change is approved or No, request is not approved but additional actions will be taken to make the
request acceptable

Rejected – The change request will be rejected and no further action will be taken.

Detail of Action Taken – Document all actions required to complete Notice or Change. Document any important information related to
this Notice or Change.




Authorization:
Engineering: ______________________________________                         Date: ____________

    Control Products                                                                                          Uncontrolled Document
Marketing: ________________________________________      Date: ____________
Commodity Manager: _______________________________       Date: ____________
Supplier Performance Engineer: _______________________   Date: ____________




   Control Products                                                           Uncontrolled Document

								
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