Supplier Quality Material Report

Supplier Quality Material Report

SUPPLIER QUALITY MATERIAL REPORT (SQMR)

This form is to be used when requesting acceptance byL-3 Combat Propulsions System (L-3CPS) of material containing minor non-conformances that are not capable of rework to specification configuration. The request will be processed by the Supplier Quality Assurance (SQA) Dept to obtain the necessary approvals allowing shipment of the described hardware with the defined discrepancy.
Please fill out form completely and email to your L-3 CPS SQA commodity lead, commodity buyer agent and
cc:
PRODUCT AS DESCRIBED BELOW IS NOT TO BE SHIPPED UNTIL AUTHORIZATION IS RECEIVED FROM L-3 CPS SQA / DATE SUBMITTED:
PRODUCT AS DESCRIBED BELOW IS NOT TO BE SHIPPED UNTIL AUTHORIZATION IS RECEIVED FROM L-3 CPS SQA
SUPPLIER: ______
P.O. NUMBER: ______
CONTACT: ______
EMAIL: ______/ VCN NO: ______
L-3 CPS BUYER: ______
PHONE NO.: ______/ PART NO:______
SPECIFICATION REQUIREMENT:
DEVIATION FROM SPECIFICATION:
ROOT CAUSE:
CORRECTIVE ACTION:
Short Term:
Long Term:
Note: If long term corrective action requires a Technical Data Package Change the Material Problem Report Number must be attained from the Buyer and included in long term action.
NUMBER OF PARTS DISCREPANT: / DISCREPANT SERIAL NUMBERS:
NUMBER OF SHIPMENTS WHICH WILL CONTAIN DISCREPANCY:
BEGINNING DATE: / ENDING DATE:
USE ATTACHMENTS IF NECESSARY
ALLOW 2 WEEKS FOR PROCESSING

SQMR FORMINSTRUCTIONS FOR COMPLETING

  1. SUPPLIER
/ Enter the name of your company
  1. VCN NO.
/ Enter the "Supplier Number" from the top of the Purchase Order (PO)
  1. PART NO.
/ enter the L-3 CPS Part Number of the material being submitted
  1. P.O. NUMBER
/ Enter the PO number
  1. L-3 BUYER
/ Enter the L-3 BUYER AGENT
  1. CONTACT
/ Enter the name of the person in your organization who is knowledgeable of the issue and may be contacted if necessary to answer questions concerning the request.
  1. PHONE NO.
/ Enter the complete phone no. for the contact (incl ext)
  1. E-MAIL ADDRESS
/ Enter the E-Mail address for the contact
  1. SPECIFICATION REQUIREMENT
/ State the drawing/spec requirement (with tolerance)
If more than one use alpha designators
  1. DEVIATION FROM SPECIFICATION
/ State the out of tolerance condition for each designator.
  1. ROOT CAUSE
/ State the cause for the out of tolerance condition for each designator
  1. CORRECTIVE ACTION
/ Short Term Explain the immediate correction to preclude additional product from containing the same discrepancy associated with each designator
Long Term Describe the systemic closed loop correction (include implementation dates) associated with each designator. Note: If long term corrective action requires a Technical Data Package Change the Material Problem Report Number must be attained from the Buyer and included in long term action.
  1. QUANTITY OF PARTS DISCREPANT
/ For each designator, list the quantity of parts discrepant
  1. SERIAL NOS OF DISCREPANT PARTS
/ Enter the serial nos.of the discrepant parts if applicable
  1. NUMBER OF SHIPMENTS WHICH
    WILL CONTAIN DISCREPANCY
/ If at all possible, it is preferred the discrepant lot be shipped as a single shipment.
  1. BEGINNING DATE
/ Enter the anticipated date of the first shipment of discrepant material.
  1. ENDING DATE
/ Enter the anticipated date of the final shipment of discrepant material.
NOTE: If approved for shipment, discrepant material must be shipped as its own lot and not co-mingled with conforming material.

FORM NO. 668-4-1 Page 1 of 2

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