Cover sheet ISIR (Initial Sample Inspection Report)

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1 Cover ISIR (Initial Sample Inspection Report) Supplier: [Company Name] Electronic GmbH [Street, Number] Your company address Montafonerstr. 8 [Postal Code] [City] AT-6780 Schruns [Country] Österreich Reason for inspection New part Prototype Change of production process Requirements of Product change Relocation of production New sub-supplier Long production interrupt mark appropriate selection(s) Scope and extent of inspection attachements: 01 Functional test 04 EMC test 07 Transport Packaging 02 Dimensional check 05 Reliability test 08 Certificate 03 Material test Chemical checklist 06 Process capability 09 Others mark appropriate selection(s) + add attachement(s) Supplier Code-No. Supplier: supplier no. acc. order (see 1) Code-No. : Insp. report No. Vers.: your report no. start Insp. with Report 1; No. Vers.: every Part description: part description (see 2) additional Part description: Part No. Rev.: (see 3) (see 4) sample Part No. Rev.: Drawing No. Rev.: inspection of like part no. except. drawing of third party Drawing No. Rev.: the same part Status Date: date of release (see 5) +1 Parts list Index.: in case of a complete unit Parts list Index.: Modification No. vers. of drawing (see 6) Order Call-off No. Date: Delivery note No. Date: Quantity delivered: Batch No:: Sample weight: Confirmation: It is hereby confirmed, that the sampling has been carried out according to VDA Volume 2 Chapter 4. your delivery no. quantity Your confirmation your batch no. acc. tested sample for possible comments from your side acc. order no. (see 7) Modification No. Incoming Goods No. Date: Quantity delivered: Batch No.: Sample weight: Released When returning Decision Conditionally released Rejected, re-sampling required Concession No: Delivery note No. Date: Total filled by According to scope and extent: TelephoneFax: Your contact person QMQA Contact data incl. address TelephoneFax: Date Signature Date Signature Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 1

2 Content of sampling documents Supplier: Code-No. Supplier: supplier no. acc. order (see 1) Code-No. : Insp. report No. Vers.: your report no. Insp. Report No. Vers.: Part description: part description (see 2) Part description: Part No. Rev.: (see 3) (see 4) Part No. Rev.: Drawing No. Rev.: like part no. except. drawing of third party Drawing No. Rev.: Parts list Index.: in case of a complete unit Parts list Index.: Attachments 01 Functional test 02 Dimensional check 03 Material test Chemical checklist 04 EMC test 05 Reliability test 06 Process capability 07 Transport Packaging 08 Certificate 09 Others Status Date mark appropriate selection(s) ;+ StatusDate of attachement(s);+ Type, extent and identification of Attachement Remarks supplier: for possible comments from your side TelephoneFa Your contact person QMQA Conact data incl. address Date Signature Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 2

3 Product related test results Supplier: Code-No. Supplier: supplier no. acc. order (see 1) Code-No. : Insp. report No. Vers.: your report no. Insp. Report No. Vers.: Part description: part description (see 2) Part description: Part No. Rev.: (see 3) (see 4) Part No. Rev.: Drawing No. Rev.: Parts list Index.: like part no. except. drawing of third party in case of a complete unit Drawing No. Rev.: Parts list Index.: Ref.- No. Requirements 1 spec. dimension 1 incl. control limits 2 spec. dimension 2 incl. control limits IST-value supplier Part 1 Part 2 Part 3 your measured value 1 your measured value 2 IST-value Specifikation complied Part 4 Part 5 Part 1 Part 2 Part 3 Part 4 Part 5 Yes No Gantner measured value 1 Gantner measured value 2 Mark appropriate selection. In case of No a coordination with the QA department of Electronic GmbH is necessary BEFORE sending Send the ISIR report in advance by to WE-Protokoll@gantner.com and the original ISIR report (incl. Signature(s) ) by post, Confirmation supplier Decision GATNER: Released Rejected, re-sampling required Your contact person QMQA TelephoneFax: Contact data incl. address TelephoneFax: filled by Date Signature Date Signature Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 3

4 Possible photo documentation Description Picture, graphic measurement results, thermoscan,. Example: wrong hole diamenter; edges not burr-free; Possiblity of documentation for manufacturing Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 4

5 Purchase order "initial sample" Max Mustermann Gutstrasse Bludenz Österreich Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 5

6 Drawing 3. Created byon: Angeli M Modified byon: Angeli M TlV04.00DocV02.00 Released byon: Seidlich G Seite 6

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