FMEA No.

: __________________
Design FMEA
Page :___________ of ________

ITEM : DESIGN RESPONSIBILITY : Prepared By. : ________________________________________

MODEL YEAR(s) / VEHICLE(s) : KEY DATE : _______________________________________________________ FMEA date ( Orig. ) __________________ ( Rev.) ___________

ITEM
O Responsibility &
Potential Failure Potential Cause(s)/Mechanism(s) of c Current Design Current Design
Potential Effect(s) of Failures s c D R Recommended Action(s) Target Action Results
Mode e l Failures c Control Prevention Control Detection e P Completion Date
v a u t N
s r e S O D R
Function s e c Aciton Taken e c e P
v c t N

MQS/APQP/F/04 Rev. : 01 05/10/02

 FMEA No.: __________________
Design FMEA
Page :___________ of ________

ITEM : DESIGN RESPONSIBILITY : Prepared By. : ________________________________________

MODEL YEAR(s) / VEHICLE(s) : KEY DATE : _______________________________________________________ FMEA date ( Orig. ) __________________ ( Rev.) ___________

ITEM
O Responsibility &
Potential Failure Potential Cause(s)/Mechanism(s) of c Current Design Current Design
Potential Effect(s) of Failures s c D R Recommended Action(s) Target Action Results
Mode e l Failures c Control Prevention Control Detection e P Completion Date
v a u t N
s r e S O D R
Function s e c Aciton Taken e c e P
v c t N

MQS/APQP/F/04 Rev. : 01 05/10/02