1.0 SOFTWARE information
1.1 Software Name and Version
1.2 Software Designation (from Form 2033) (check one)	1.3 Software Risk Level
☐	Safety Software: SSS (Safety System SW)	☐	1	☐	2	☐	3
☐	Safety Software: SHADS (Safety Hazard Analysis SW and Design SW)	☐	1	☐	2	☐	3
☐	Safety Software: SMACS (Safety Mgmt. and Administrative Controls SW)	☐	1	☐	2	☐	3
☐	Non-safety: Risk Significant Software	☐	1	☐	2	☐	3
☐	Non-safety: Commercially Controlled Software	N/A

2.0 SWTM REVIEW & APPROVAL
The following reviewers have reviewed this SWTM for conformance to traceability requirements and approve it for the subject software.
2.1. Name (last, first)	2.2. Z No.	2.3. Role	2.4. Signature and Date
SO	SRLM	Other
☐	☐	☐
☐	☐	☐
☐	☐	☐

3.0 REVISION HISTORY
3.1. Revision	3.2. Date	3.3. SWTM Revision Description and Reason

4.0 TRACEABILITY MATRIX
4.1 Test Plan(s)
4.2 Requirement Source	4.3 Software Requirement (No. and Topic)	4.4 Design Location	4.5 Code Location	4.6 Test Case No.
Sample text: LANL Prime Contract, App. G, NNSA SD 1027, Change Notice 1	R 1.2 Hazard category radionuclide threshold quantities	Software Design Document (SDD) 201, § 4.2.2	Read_Blk_TQs Ver_Blk_TQ	STC TQ011; STC TQ012; STC TQ013

General

This template may be used to implement the software traceability requirements of P1040, Software Quality Management. Use of this template is not mandatory; other templates or formats may be used. Enter N/A for fields that are not applicable.

The SWTM is a required part of the software baseline. Whenever information in the SWTM changes, this form must be revised and the baseline updated accordingly.

For additional information on the software requirements traceability matrix, see P1040, Sections 3.5 and 3.6, or contact an SQA representative at p1040@lanl.gov.

Remove sample text and these instruction pages prior to finalizing the SWTM.

HEADER

Enter the Document ID (e.g., number or letter) and Revision Number for the SWTM, per the governing document control process.

Enter the document Effective Date.

1.0 SOFTWARE INFORMATION

Field	Entry Information
1.1	Enter the name and version number of the software.
1.4	Indicate the software designation from Form 2033. Check only one box.
1.3	For Safety Software and Non-safety, Risk Significant software, select the Software Risk Level (SRL) from Form 2033. Check only one box.

2.0 SWTM REVIEW & APPROVAL

Field	Entry Information
2.1	Enter the name of those who must review and approve the SWTM.
2.2	Enter the Z number (if applicable). Enter N/A if not applicable.
2.3	Check the box for each role the reviewer is filling. One individual may occupy multiple roles. If an additional role is required, add the role in the field entitled “Other”.
2.4	Enter the date and sign that the SWTM was reviewed and approved.

3.0 REVISION HISTORY

Field	Entry Information
3.1	Enter the SWTM revision number (or letter). Retain prior revision numbers and associated information.
3.2	Enter the date the revision takes effect (effective date).
3.3	Enter a summary description of SWTM revision and the reason for the revision.

4.0 TRACEABILITY MATRIX

Field	Entry Information
4.1	Enter the associated test plan(s) document number and title.
4.2	Enter the requirement source. Sources are typically documented in a software requirements document. Examples of other documented sources include contractual (i.e., Prime Contract) requirements, Documented Safety Analysis (DSA) requirements, etc.)
4.3	Enter the software requirement number and topic derived from the requirement source. The software requirement number is found within the software project documents (e.g., system requirements specification, software requirements specification, procurement documents). The requirement number must be unique to the requirement. The topic is a few brief words that summarize the general requirement area or topic. (e.g., Software Reports, Emergency Shutoff, Error Notifications, etc.). The associated requirement document number may be included.
4.4	Enter the design document number and section that address the associated requirement (e.g., Software Design Description, Section x.x.x). Note: This field does not apply to acquired software where design or design revisions are not applicable. Enter N/A or delete this field if it is not applicable.
4.5	Enter the location in the computer program code (e.g., block title, unit title, etc.) where the associated requirement is implemented. Note: This field does not apply to acquired software where design or revisions are not applicable. Enter N/A or delete this column if this field is not applicable.
4.6	Enter the test case number(s) used to verify the associated requirement. All testable requirements must each have at least one test case; however, one test case may address multiple requirements.