RAW MATERIAL EVALUATION

DATE :

Division :

Material Name :
Principal :
Supplier/vendor :
Contact person :
Phone / Fax :
Result / Remarks/Comments/Reason (please fulfilled) :

Quantity of sample :

Documents : Specification* MSDS** Report analysis

Halal certf.* ………………………… CoA**

Unit of Price :

Activities : Analysis (Pls see attachment) …………………………

Approved by MUI :
SK no. ……………………………….. Date:………………………………

: Sensory Evaluation
: Lab scale test
: Production trial
: Others …………………………………………………………..

Completion date

Result / Remarks/Comments/Reason (please fulfilled) :

Final result : Accepted

Rejected
Suggestion :

Name Signature Date

Distributed by

Received by

Reported by

Approved by
Acknowledged by
(KMHI)
Remarks :

* mandatory
** tentative