Department/Section: _______________________

Initiated By (Name):____________________
Description of Proposal: ________________________________________________________
______________________________________________________________________________
Changed Parameters/Quantities
Old New

Reason for The Proposal:

______________________________________________________________________________
____________________Signature of the Initiator____________Date _________________
Comment of Production Manager
________________________________________________________________________
Name ______________________________ Signature_______________
Comment of QA
Manager______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Name ______________________________ Signature_______________
Comment of Plant
Manager______________________________________________________________________
Name ______________________________ Signature_______________

Confidential