PPAP Approval Request
Tesla Part Number: Revision:
Tesla Part Description: Tesla Program(s):
Supplier Part Number (if applicable): Supplier Revision:
Engineering Change Order (ECO): Dated:
Purchase Order #: # Parts: Weight (kg):
SUPPLIER SUPPLIER MANUFACTURING LOCATION
Supplier/Vendor Code Supplier Company Name/Division
Address 1 Address 2
City Region/State Country Postal Code
MATERIALS REPORTING GADSL Declaration of Conformance (IMDS) Yes No
Does this part contain any restricted or reportable substances? Yes No n/a
If a new revision, has the reportable material content changed? Yes No n/a
Safety and/or Government Regulation Yes No
Regional Certification / Partmark Required? Yes No
Deviations/Comments? Yes No
REQUIRED SUBMISSION REASON FOR SUBMISSION
Initial Submission
PPAP Approval Form (and Appearance Approval Report if required)
Design Change(s)
PPAP package with product samples, complete supporting data, and other requirements as specified by TESLA
Process/Tooling/Machine: Transfer, Replacement or Refurbishment - PCR Attached
TESLA audit at manufacturing location (If requested by TESLA QE)
Sub-Supplier or Material Source Change - PCR Attached
Other - please specify below:
SUBMISSION RESULTS
MEETS MEETS
YES NO N/A TESLA QE YES NO N/A TESLA QE
Supplier Quality Contacts Raw Material Certifications
Quality Assurance Schedule Sample Parts, Data, and FAI
Part Evaluation Plan Quality Readiness Checksheet
Inspection Standard
Rev:____ Date:_______ PFS - No Critical Quality Concerns
Process Flow Chart HVPT and Capacity Study
Control Plan Appearance Standard and AAR
PFMEA Other:
Capability Results for Critical Characteristics
These results meet all drawing and specification requirements: Yes No (If "NO" - Explanation Required)
Mold / Cavity / Production Process Represented:
Is each Customer Tool properly tagged and numbered according to Tesla Motors Asset Management Requirements? Yes No n/a
DECLARATION
I hereby affirm that the samples represented by this warrant are representative of our parts which were made by a process that meets all AIAG Production Part Approval Process
Manual 4th Edition Requirements including all Tesla Motors additional requirements. I further affirm that these samples were produced at the production rate of __/__hours.
I also certify that documented evidence of such compliance is on file and available for review. I have noted any deviations from the declaration below.
EXPLANATION/COMMENTS:
AT MINIMUM, THE SUPPLIER IS EXPECTED TO MAINTAIN THE APPROVED LEVEL OF QUALITY
Supplier Authorized Signature: Date:
Print Name: Phone #:
Title: E-mail:
Part Warrant Disposition: FOR TESLA USE ONLY
Approved
Reason:
Interim PPAP Approval
Rejected
Tesla Quality Engineer Signature: Date:
Tesla Design Engineer Signature: Date:
Tesla Purchasing Signature: Date:
Routing: Supplier TESLA QE CC:Supplier
TESLA Design
Rev 04
CC: TESLA Purchasing
BMS-0000163 rev 03