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Investigation and Corrective Action Request

Revision: a
FIELD NAME:   FIELD VALUE: 
Investigation and Corrective Action Request
ICAR No:   Part No:    
Supplier:   Part No Rev:   PO No:  
Program Name:   Process Affected:   RFS Number:  
Raw Material:   Heat No:   Material PO No:  
Supplier Responsible Authority:   Supplier Team Members:  
Problem:

Estimate Contain/Control By:   Actual Date Controlled:  
Supplies in Transit:   Supplies In-Process:   Finished Supplies:  
Supplier RFS Started: Yes  No  RFS No:   Qty Quarantined:  
Pending Orders Evaluated: Yes  No  Evaluation Details:

Until permanent corrective action is implemented, the situation will be controlled by:

Root Cause:

How Root Cause was Verified:

Corrective Action:

How Corrective Action was Verified.

Record source of objective evidence (training records, revised procedures, etc):

Similar Parts Affected:

Effective Date of Corrective Action:  
Company Approval:   Company Approval Date: