PRODUCT QUALITY ANALYSIS REQUEST FORM Rev. 1

Requestor: ______Date: ______

Required Information: (* Minimum information required to process your request)

*Company Name: ______

*Customer Contact Name: ______*Phone #: ______

*Email ID: ______

*End Customer (if different than Company above):______

*Product Purchased from:______

*Fairchild Part #: ______ *Quantity Returned: ______

*RequestType:  Analysis of Production part  Other (______)

Analysis of Engineering Sample

*Failure Location:  Incoming Inspection  Board level test

Board MountingBurn-in

SolderingSystem Level test

In-circuit TestField (at end customer)

*Test Condition:  Administrative (e.g. labeling problem, wrong part, packing problem)

Electrical (e.g. open, short, AC timing, leakage)

Visual Mechanical (e.g. bent leads, cracked package)

*Problem Description: ______

______

Please Note: Products with missing, broken or otherwise damaged leads/pins may not be electrically testable which will impact our ability to verify the failure.

Please supply followingadditional information and details if applicable.

Additional Information:

Customer Part #: ______Customer P.O. #: ______

# Parts Returned: ______Date Shipped: ______

Package Type: ______Device Top Mark: ______

Date Code(s): ______Lot Trace Code(s): ______

Product Lot #: ______Customer Reference #:______

Circuit Schematic Available?YesNoSample Board Available?YesNo

Has Fairchild part been used in this application before?YesNo

Your Mailing Address (if you would like samples returned)

______

Details:

Failure Type: ShortOpen

FunctionalDC Parametric

AC / TimingInput / output not changing

Brightness / intensity / hueOther (______)

Time to Failure: Initial Power On Failure(______) Minutes/Hours

(______) Months(______) Years

Failure Temperature: Room TemperatureLow Temperature (_____C)

High Temperature (_____C)Variable (____C to ____C)

Operating Voltage: Min. Spec LimitNominalMax. Spec Limit

Description of Timing: ______

Input Driven By: ______Output Driving: ______

Have you experienced a similar problem with this device before? YesNo

If yes, can you provide the Fairchild PQA #? ______

What Is The Level Of Failure ?

Field reliability problem orgreater than 10% component defect level

System level failures or1% to 10% component defect level

Veryhigh component defect level (>100ppm - 10,000ppm)

Higher than normal component defect level (>10ppm - 100ppm)

Low component defect level (<10ppm)

What Is The Impact Of The Failure?

Creates a serious product safety problem.

A recall from the field is likely due to reliability concerns.

Causing a line down situation.

Missed shipments of final product.

Causing a re-schedule of production plans.

Results in very high level of board rework (>2%)

Results in a moderate level of board rework (1% - 2%)

Results in a small amount of board rework (<1%)

 “Normal” line fall out, being tracked for corrective actions.

No impact, no corrective action required at this time.