Date :


Initiator Name & Designation:



Department Name:



Description of Initiation:






Reason for Initiation:





 Document Name: ( To be Initiate)

Revision No:

Doc No:

Initiator Name                           

Signature & Date

Department Head Name           

Signature & Date

To be Filled by Department Head

Impact of Initiation:




Department Head Name:  



Signature & Date:

To be Filled by Quality Assurance Department

Feasibility of Initiation                Yes                   No

Status:                                        Approved         Not Approved

Date of Implementation of Initiation of document:

Initiated document distributed to


      HOD Production Department                                   HOD Ware House Department     

      HOD Quality Control  Department                           HOD HR & Admin Department

      HOD Quality Assurance Department                        HOD Accounts Department

Final Approval and Authorization:

Quality Assurance Manager/MR

Signature & Date: