Supplier Change Request
SCR #
Email completed form to:CPSD-SCR@Eaton.com
Please submit this notification at least 90 days prior to the planned change implementation!
Supplier Information:
Date of Request
Supplier Name
Supplier Number
Supplier Location(s)
Supplier DUNS#
Supplier Contact Name
Supplier Contact Title
Supplier Contact Email
Supplier Contact Phone #
Supplier Fax #
Eaton Purchasing Contact
Date of Proposed FUTURE Change
Cost Impact ($/each.. increase or decrease)
Description of Change (Please describe in detail the nature of the change)
NOTE: The SCR is used to autorize submission of samples only. It is not an authorization to proceed with implementation of a change on a permanent basis.
DECLARATION:
I hereby certify that representative samples will be manufactured using the revised product and/or process and verified, where appropriate, for
dimensional change, appearance change. Physical property change, functionally for performance and durability. I also certify that documented
evidence of such compliance is on file and available for customer review.
Supplier Representative Signature/Date:
Design responsibility:
Eaton
Supplier
Customer Information: (Please list additional impacted part numbers on a separate sheet if necessary)
Supplier Part #
Rev:
Customer Part #
Rev:
Customer Location(s) Affected (city,state)
ALL Information below is to be filled out by Eaton representatives
Eaton Requirements
Purchasing
Timing Plan Received
Supplier Quality
PPAP Required?
Yes
No
Date SCR Received
Yes
No
Level
Due Date
Additional Requirements
This approved form must accompany your PPAP submission
Approval Signatures
Signature
Date
Purchasing Representative
Engineering Representative
Supplier Quality Representative
CPSD QC SQ 001. F9