Godrej & Boyce Mfg. Co. Ltd.

Security Solutions Division

Tool / Component Approval Request Note
FL/QAD/F/104
Rev : 00
Date : 23/06/11

Date: _______________

From: ________________ Department

To,
Q.A.D.

Kindly arrange to inspect the item sending herewith as per details given below:

Item description :_______________________________________________________

Drawing No. : __________________________

Item code : __________________________

Supplier : _______________________________________________________

Challan No. : _______________________ Date:___________________________

Qty. Supplied : ______________ Qty. given for checking : ____________________

Tool No. : _____________________

Reason for Inspection : __________________________________________________

__________________________________________________

Parameters to be checked :

1)                 ________________________________________________________________

2)                 ________________________________________________________________

3)                 ________________________________________________________________

4)                 ________________________________________________________________

5)                 ________________________________________________________________

_______________
(Signature)

Name: ______________________