CORRECTIVE / PREVENTIVE ACTION

REPORT (CAR/PAR)

CORRECTIVE / PREVENTIVE ACTION REQUEST

ASSIGN TO

ISSUED BY

Corrective Action Request (CAR)

Preventive Action Request (PAR)
CAR / PAR NO. :

NON CONFORMITY OBSERVED DURING

CUSTOMER COMPLAINT

Yes

LOCATION / DEPT

PRODUCT :

Internal Audit

Others

Customer Audit/ Complaint

No
REQUEST DATE :
09 Juni 2016

DESCRIPTION OF NONCONFORMITY / COMPLAINT / ISSUE

FINDING TYPE
:
Major
Observation

REPLY DUE DATE :

ASESSOR :

Minor
OFI
INVESTIGATION AND RESPONSE:

ROOT CAUSE ANALYSIS :

CORRECTION & CORRECTIVE ACTION TAKEN / PREVENT ACTION TAKEN :

Correction :

Corrective Action Taken :

SIGNATURE/TITLE:

Preventive Action Taken

DATE :

DATE CAR/PAR COMPLETED:

ROOT CAUSE KEY WORDS:

ACTION TAKEN KEY WORDS :

Release JO and leader monitor

C/A APPROVED BY:

VERIFIED BY :

ACCEPTABLE:
Yes

CAR/PAR CLOSED :
No

Yes

No

IF NO, FOLLOW-UP CAR NO :

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