Engineering Approval Form

Customer Engineer:
Part Number: Part REV
Part Name:
Supplier Name: Supplier P/N:
Usage (Optional) Product Yearly Volume:
Class:
Module: Expected Prod. Buy Date:
ADDITIONAL Part Info 1) Has supplier been approved?
2) Is the part IMDS compliant?
3) Is the part UL/CSA compliant?
Comments / Justification Release #

APPROVALS

Design Engineer:
al Form

Yes No N/A
Yes No N/A
Yes No N/A