Item Creation Form

ITEM INFORMATION:	Date: 4/28/2021

Special Characters ° (Alt – 0176) ± (Alt – 0177)	µ (Alt – 0181)	¼ (Alt – 0188) ½ (Alt – 0189)

ORIGINATOR:

ITEM NUMBER:

ITEM DESCRIPTION:

PRODUCT CODE:	other

PROTOTYPE:	Yes	No	N/A

TYPE:	Material	Fixture	Tool	Other

SOURCE:	Purchased	Manufactured	Transferred

UNIT OF MEASURE:

MANUFACTURER’S NAME (Use “GENERIC” for Any.)	MANUFACTURER’S PART NUMBER

DRAWING NUMBER:	(If applicable)

DRAWING REVISION:	(If applicable)

INSPECT INCOMING ITEMS: No Yes (If yes, fill in box below)

Inspection requirements:

Required for all parts:

Hazardous or Controlled Material:	Yes	No

ATEX:	Yes	No

ABC Code:

RoHS Status:

FG Type:

Item Creation Form

Required for all finished goods:

(Items in blue are provided by sales / marketing)

Kit Flag:	Yes	No

Military Use:	Yes	No

ECCN:

Schedule B #/
HS Tariff Code:	or other

Allocation Method:	- 2 Location/Lot/Serial Allocations

Place on Pricelist?	Yes	No

Serialized Product to be tracked in LD Database? Yes	No

US list price:	Repair Pricing:

Int’l list price:	Repair Code:

Int’l Dist Net:	Calibration Pricing:

Target COGS:	Calibration Code:

Service Item:	Yes (item not eligible for field sales commission)

Marketing Description:

Additional Notes or Specification:

DOCUMENT CONTROL:

DATA ENTRY CLERK:	DATA ENTRY DATE:

QC Items fields completed:	Yes	Who:	Date:

Export Control Review:	Yes	Who:	Date: