Process Change Request

Form
MPPL/MR/FRMT/02
Issue No. & Date: 01/04.04.2021
Makarjyothi Polymers Pvt. Ltd.
Rev. No. & Date: 00/01/04.04.2021
To be filled by PCR initiator/Originator

Change Requested by Submitted on

Contact Details

Change Request Details

 Policy  Process  Procedures

1. Area of change (tick the correct option)  Staff  Contracts  Assets

 Other? Please specify

2. Is this the change of information Security – Risk Management Action?  Yes  No

3. Details of proposed change:

 Describe proposed change.

 Why proposed change should be approved? Explain.

 What are the consequences if proposed change is not implemented? Explain.

1 Internal
 Attachments:
1.
2.
3.

2 Internal
 For official use only

To be filled by the General Manager

CR Number CR Priority High / Medium / Low

To be filled by the Change Management Committee

Reviewed by Reviewed on

Change request is  Approved  Approved with conditions  Rejected  Delayed till:

Change Date Change Owner

 Procedure used to reverse change if it fails to achieve desired results:

Rollback Plan

Conditions /
Remarks

3 Internal