ABC (Pvt.

) Limited Issue # 00

COMPLAINT ACTION FORM

CAF # : _______
SECTION A – Reporting
Reported By: Reporting Date: _______________

Reporting Department:

Category of Request: Customer Complaint User Complaint

Production / Quality Nonconformance
Systems Nonconformance Suggestion / Others
Nature of Problem (Product & Order Details, in case of customer complaint):

CEO / MR: ________________ Date: _______________

SECTION B – Analysis
Assigned for Analysis to: Target Date: _______________
Root Cause Analysis:

Analysis By: _______________ Date: _______________ Time: _______________

SECTION C – Implementation
Corrective (Immediate) Action Taken:

Preventive Action Identified:

SECTION D – Verification
Action Completed (Verification Comments):

Accepted Rejected
CEO / MR: ______________________________ Date: _______________

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