Supplier Change Request Form Completion Instructions
Section 1: To be filled out by the supplier:
1. Supplier Information
-Supplier: The name of the supplier
-MFG Address: The manufacturing address associated with the request
-Date of Request: Date request submitted to Raytheon
-Supplier Reference Number: An internal tracking number used by the supplier (optional)
-Requestor: name, phone number, fax number, and email address of the agent at the supplier requesting the change
-Raytheon (RTN)Purchase Order (PO) Number: The purchase order number affected by the change
-Contact information of the requestor: Originator name, phone number, fax number and email address
-RTN Buyer Name: Name of the Raytheon buyer, phone number and email address
2. Part Number - Include: part number, revision level (from RTN drawing), quantity affected, date effective,serial number, and date and lot code affected by the change.
3. Part Description - Description of the affected part.
4. Inventory status(Check all that apply)- Existing inventory, parts currently being produced or future product.
5. CurrentState - Provide specific information related to the purchase order, including program name, description of requirement, past history of procurements within the last 12 months, past negotiations, supplier capabilities and any other related details pertaining to the requirement.
6a. Reason for Change (Check all that apply)
-Plant Relocation
-Process Change
-Name/Cage Code Change
-Equipment Relocation
-Material Change
-Drawing Conflict
-Change to RTN Directed Sub-tier Supplier
-New Equipment
-Design Change
-Other
6b. Change Details - The Seller is required to inform the Raytheon Buyer of all changes incorporated to the technical design, specifications, or acceptance process used to produce the hardware item, including a brief description.
7a. Risks (Identify all risks associated with this change request) - The impact of the proposed change on technical, schedule, cost, quality, and other risks.
-How the change affects deliveries
-Estimated production effectively point for the change (i.e., serial number, lot number, etc.)
-Impact to the purchase order price
7b. Status of Job- Currently active, cancelled, or on-hold.
7c. List Potential risks and explain plans to mitigate- Document your rationale for any risk and provide a detailed plan to mitigate the risks.
8. Date supplier needs response (to not jeopardize delivery date)- The date the supplier needs a response from RTN.
9. Attachments(as applicable)– Check either Yes or No(retained by buyer).
Section 2: To be completed by Raytheon (RTN):
10. Program Information(To be filled in by the Buyer and MPM)
10a. Program Name
10b. Action Tracking number
10c. Supplier ESD number
10d. MRP need date: - for product (if applicable)
10e. Open POs (Yes or No)
11. MPM Name- MPM Name and Date
12. MPM assigned to:
12a. Program Engineering name and date
12b. Quality Representative name and date
13. Change Request Disposition (determined by Program Engineering or QA)
13a.Check all that apply
Major Change (Class I): A change that affects the specified requirements for product attributes, including safety, reliability, and supportability. A change that affects compatibility with interfacing products, including such products as test equipment, support equipment and associated software, and products furnished by a customer or thataffects any of the following:
Product operation
Interchangeability of replaceable products, assemblies, or components
Addition of a non-qualified supplier
Operator or maintenance training
Requires retrofit of delivered products
A major change would also include cost impacts to RTN, including incentives and fees, and contracted deliveries or
Minor Change (Class II): A change that has little or no impact to the function, interchangeability or supportability of the product. This would include minor changes to correct or modify configuration documentation or processes without impacting interchangeability of product elements and would not impact customer requirements (i.e., should be invisible to the customer).
Editorial Changes: Changes that have no affect on the product (records only). An editorial change is considered a correction to spelling, typographical, photos and/or grammatical error.
Additional Change Descriptions: Check all that apply
Equipment relocation
Plant relocation
Acquisition and Mergers
New Equipment
Other
13b. Change Request Number (if applicable)
13c. Actions
13d. Actionee, Due Date and Closed Date
13e. Disposition- Buyer to notify supplier of the disposition of the change either Accepted, Rejected and the date.
13f. Comments- actions taken to disposition/close change request with the supplier.
14. Buyer Closure with Supplier -Buyer Comments, Name and Date (Buyer to follow Record Retention Business Practices)
15. Business Specific Approvals (refer to business directives for guidance)– Signature of Program Quality and Program Engineering if applicable to your business process.
Raytheon reserves the right to request any documentation associated with engineering or process change requests submitted for approval or concurrence.
BE_2_instructions.doc1 of 47/9/2010