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Company Name
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Quality Assurance Department
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Recall Action Plan
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Form No.
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Revision
No.:
Issue
Date:
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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:
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S.#
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Agent / Distributor Name
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Contact Person & No
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Contacted on and By
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Qty Delivered
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Qty Returned / Date
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Qty
Diff /Sold
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Total
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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
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