DESIGN CHANGE FORM

FORMAT NO.:

DATE : .................................
PART NUMBER : ......................................................
PART NAME : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . .
CUSTOMER NAME : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DESCRIPTION OF PART

VALIDATION | EXPLAINTION FOR CHANGE

CHANGE APPROVED? - [ ] YES [ ] NO

DRAWING CHANGED DATE: .................................

CHANGED BY : .............................................................. SIGNATURE: .................................

PROJECT ENGINEERS /PROJECT MANAGER SIGNATURE: .................................

QUALITY ENGINEERS SIGNATURE: ........................... QUALITY MANAGER SIGNATURE: ..............................

CUSTOMER APPROVAL NOTE SIGNATURE & STAMP