Receipt No :

4M Change Request Request Date :

Supplier Name :ALLIED STAMPING
Ecocat Received by :
Submitted by : JAGJIT Ecocat Reviewed By
:
(Name/Designation/Deptt.)
Head SCM Quality Head
We would like to request 4M Change as per below details
1. Part Details

P/Name : Part List Attached P/No : Model Name : Model List Attached

2.Change reason ( Click related area)

1) Man Change
□ Major/special process worker Change □ Quality Head change

2) Machine Change
□ Old to new production Line installation □ Another production facility installation (Same model)
□ Facility moving (in house/out of company) □ Duplicate Mold/Tool/Jigs/Fixture of existing model

3) Method Change
□ Production place change □ Sheet Metal/Molding condition change, □ Major work condition change
□ Inspection Method change (SQA / In-Process / PDI) □ Sub - Supplier change,
□ Process outsourcing at sub supplier or moving from sub supplier to in-house
□ Packing method change □ Working method change

4)Material
□ Parts material, grade change, □ Hazardous material change
□ Use of Old raw material □ Change in material properties □ Change in sub material like oil, solvent (Flux),Protection Vinyl,
□ Brazing Gas change

5) Other
□ Organization Name Change

3.Explanation of Change

Before Change After Change

4. List of attached documents

5.PPAP Sample Submitted Qty.:

Approval request date :18/03/2018

FM/ML/000