Cover sheet ISIR (Initial Sample Inspection Report)
Supplier:
GANTNER
[Company Name]
GANTNER Electronic GmbH
[Street, Number] [Postal Code]
Your company address
[City]
[Country]
Montafonerstr. 8 AT-6780
Schruns
Österreich
Reason for inspection New part / Prototype
Change of production process
Product change
Relocation of production
New sub-supplier
Long production interrupt
mark appropriate selection(s)
Requirements of GANTNER
Scope and extent of inspection / attachements: 01 Functional test
04 EMC test
02 Dimensional check
05 Reliability test
03 Material test / Chemical checklist
06 Process capability
Supplier
mark appropriate selection(s) + add attachement(s)
07 Transport / Packaging 08 Certificate 09 Others
GANTNER
Code-No. Supplier:
supplier no. acc. order (see 1)
Parts list / Index.:
Code-No. GANTNER: start withReport 1; your report no. Insp. No. / Vers.: / every part description (see 2) Part description: additional sample (see 3) Part No. / Rev.: / (see 4) inspection of like part no. except. drawing of third party Drawing No. / Rev.: the same part date of release (see 5) +1 Parts list / Index.: in case of a complete unit
Modification No.
vers. of drawing (see 6)
Order Call-off No. / Date:
acc. order no. (see 7)
Delivery note No. / Date:
your delivery no.
Quantity delivered:
quantity
Batch No.:
Batch No::
your batch no.
Sample weight:
Sample weight:
acc. tested sample
Insp. report No. / Vers.: Part description: Part No. / Rev.: Drawing No. / Rev.: Status / Date:
/ / / /
Modification No. /
/
Confirmation: It is hereby confirmed, that the sampling has been carried out according to VDA Volume 2 Chapter 4.
Incoming Goods No. / Date:
/
Quantity delivered:
According to scope and extent:
Total
Decision
1
2
3
4
5
6
7
8
9
Released Conditionally released
Your confirmation Remarks:
Rejected, re-sampling required
for possible comments from your side
Concession No:
filled by GANTNER
When returning Delivery note No. / Date:
/
Remarks:
Name:
Your contact person
Name:
Department:
QM/QA
Department:
Telephone/Fax: Contact data incl. E-Mail address
Telephone/Fax:
E-Mail:
E-Mail:
Date
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Signature
Date
Modified by/on: ---
Signature
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 1
Content of sampling documents
Supplier:
GANTNER
Code-No. Supplier:
supplier no. acc. order (see 1)
Code-No. GANTNER:
Insp. report No. / Vers.:
your report no.
Insp. Report No. / Vers.:
Part description:
part description (see 2)
Part description:
Part No. / Rev.:
(see 3) / (see 4) acc. cover like part no. except. drawing of third party sheet
Part No. / Rev.:
/
Drawing No. / Rev.:
Drawing No. / Rev.:
/
Parts list / Index.:
in case of a complete unit
Parts list / Index.:
/
/
Attachments
Status / Date
/
/ acc. cover sheet
Type, extent and identification of Attachement
01 Functional test 02 Dimensional check 03 Material test / Chemical checklist 04 EMC test 05 Reliability test 06 Process capability
mark appropriate selection(s) ;+ Status/Date of attachement(s);+
07 Transport / Packaging 08 Certificate 09 Others Remarks supplier: Remarks: for possible comments from your side
Name:
Your contact person
Department:
QM/QA
acc. cover sheet
Telephone/Fax: Conact data incl. E-Mail address E-Mail:
Date
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Signature
Modified by/on: ---
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 2
Product related test results
Supplier:
GANTNER
Code-No. Supplier:
supplier no. acc. order (see 1)
Code-No. GANTNER:
Insp. report No. / Vers.:
your report no.
Insp. Report No. / Vers.:
Part description:
part description (see 2)
Part description:
Part No. / Rev.:
(see 3)
Part No. / Rev.:
/
Drawing No. / Rev.:
like part no. except. drawing of third party sheet
Drawing No. / Rev.:
/
Parts list / Index.:
in case of a complete unit
Parts list / Index.:
/
Ref.No.
/ / (see 4)acc. cover
IST-value supplier
Requirements
/
IST-value GANTNER
Specifikation complied
Part 1 Part 2 Part 3 Part 4 Part 5 Part 1 Part 2 Part 3 Part 4 Part 5
1 2 3 4 5
spec. dimension 1 incl. control limits spec. dimension 2 incl. control limits … … …
acc. cover sheet
your measured value 1
Gantner measured value 1
your measured value 2
Gantner measured value 2
Yes
No
Mark appropriate selection. In case of No a coordination with the QA department of GANTNER Electronic GmbH is necessary BEFORE sending
Send the ISIR report in advance by E-Mail to
[email protected] and the original ISIR report (incl. Signature(s) ) by post,
Confirmation supplier Remarks:
Decision GATNER: Released Rejected, re-sampling required Remarks:
Name:
Your contact person
Department:
QM/QA
Telephone/Fax: Contact data incl. E-Mail address E-Mail:
acc. cover sheet
Name:
filled by GANTNER
Department: Telephone/Fax: E-Mail:
Date
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Signature
Date
Modified by/on: ---
Signature
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 3
Possible photo documentation
Description
Picture, graphic measurement results, thermoscan, ….
Example: wrong hole diamenter; edges not burr-free;
Possiblity of documentation for manufacturing
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Modified by/on: ---
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 4
Purchase order "initial sample"
Max Mustermann Gutstrasse8 6700 Bludenz Österreich
7. 7.
3.
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Modified by/on: ---
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 5
6.
5.
4.
2.
Drawing
3.
DK_GANTNER-ISIR-Fill-in-help-EN_V010000.xlsx Created by/on: Angeli M./25.02.2015
Modified by/on: ---
TlV03.01/DocV01.00 Released by/on: Wachter A.02.03.2015 Seite 6
