NCR Latest Revision
NCR Latest Revision
Report Number: Customer: Model / Part Number: Problem / Affected Equipment: Nonconformance / Description: PO / Item: Serial Number:
Date: Date:
Does this Nonconformance meet 10CFR21 Reportability Requirements If needed, attach 10CFR21 Evaluation Form to this NCR Disposition:
o Yes o No
If 'Accept As Is' disposition, did the customer approve? (Attach Approval Documentation) Was a CPAR issued? o Yes o No If 'Yes', provide CPAR # Final Closeout: