Company Name
Quality Assurance Department
Recall Action Plan
Form No.
Revision No.:
Issue Date:

Product: ___________________ B. No.: _________________ B. Size:___________
Mfg. Date: ___________ Exp. Date: _________ Qty Packed (Units):_________

Prod. Manager: ____________________ QA Manager: __________________

Complaint Received On: _________ From: __________ By: _____________

Nature of Complaint: £Quality      £Safety      £Labeling      £Compliance Issue      £Other (Pl. Specify)__________________________________________________
 Immediate Action:
Stock Available in Store: ___________________ As on: ________________

Further Distribution Status: _______________________________________

Distribution Record:____________________________________________

Inventory Control Mgr: _______________ QA Mgr: ___________________
Recall and Reconciliation:
Agent / Distributor Name
Contact Person & No
Contacted on and By
Qty Delivered
Qty Returned / Date
Diff /Sold


Remarks: ____________________________________________________________

_________________                                                                                  ________________
Inventory Control Mgr                                                                                   QA Incharge
Review and Disposal:
Batch Documents Review: __________________________________________

Tests and Analysis: ________________________________________________

Other Investigation Details:_________________________________________

Final Disposal Decision: ____________________________________________

Recall Action Initiated on: __________________ Closed On: ______________

_____________                               ____________                                 ______________

Q.C. Manager                                   QA Incharge                                     Plant Manager