Supplier Request for Product or Process Change

Section 1 - To be completed by Supplier

General
Supplier: Date of Request:
Street: Supplier Contact:
City Phone Number:
State Email:
Zip Code

Request for change

Change Type:
Material Process Inspection/Test Product Facility Supplier
Equipment Packaging Mfg’s Part Number Other _________________

IR HiRel Plant(s) affected

IR Part Number: Revision:
Part Description:
Reason for Change: IR HiRel’s Request? Yes No

Description of Change:

Supplier Attachments Drawing Data Samples

Identify Impact of the proposed change:
NONE Form / Fit / Function Reliability Part Cost:$
Product Impact:
Packaging Other _________________

Proposed Change Effective Date (NOTE: Changes shall not be implemented prior to the receipt of written approval from IR HiRel):
Proposed First Lot Number Affected:

Validation/Qualification Plan with Target Date:

Associated Procedure: HBP-18 HBF-18-03 Rev. B

ECN # 1120_07850
03/03/2020
 Supplier Request for Product or Process Change
Section 2 - To be completed by International Rectifier

Additional Data Required from Supplier

None
Drawing / Design Records
Process Flow Diagram
Systems Risk Assessment
Process FMEA
Dimensional Results
Material Test Results
Material Certifications
Performance Test Results
Capability Studies
Measurement System Analysis
Studies
Process Control Plan
Sample Product
Other

Evaluation Summary:

Disposition:
Approved Rejected
Signature Date Signature Date
Supplier
Purchasing Development

Process Eng. Product Eng.

Supplier Quality Plant Quality

Change Implementation Date: Supplier Reference:

Supplier Signature:

Associated Procedure: HBP-18 HBF-18-03 Rev. B