Supplier Corrective Action Request (SCAR) Form

General Information

Supplier

Part Name & Number

PO/Lot Number

Problem Description

Photo Evidence
Action Response

Containment action completed within 48 hours of SCAR issuance

Actual completion date of containment action
Photo evidence

Person responsible for containment action

Primary root cause(s) for reject occurrence

What was done to prevent recurrence and/or defect?

Implementation date of permanent corrective action
Photo evidence

Person responsible for permanent corrective action

How will the effectivity of the corrective action be measured?

Completion

Additional comments

Quality Manager Name & Signature