Form Number

Form Revision
PROJECT VERIFICATION & SIGN OFF SHEET Created Date
Page

New Project Special Adoption Improvement Cost Down____%

STATUS
Transfer Painting New Supplier Countermeasure From :_____ __ To :_____

Model No. : Paint Maker :

Part Name : Color :

Part Number : Target Mass Pro :

Customer : Actual Mass Pro :

STAGE NOTE

CHECK
NO DOCUMENT VERIFICATION PIC DEPARTMENT REMARK
LIST
I. CHECK ITEM
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
I. REJECTION (%)

Event Reject (%)

COMMENT

APPROVAL SIGN

Marketing Purchasing PPIC Production QC Engineering

Distributed To
10 M Jmt
1
10 M sb
10 M mg 1
10 sn 1