Consumer Product Recall Incident Communication Report
Company Name
Contact Person
Position/Title
Contact Information (Phone/Email)
Date of Report
Product Name
Product Description/Model
Batch/Lot Numbers Involved
Product Category
Description of Incident
Date(s) of Incident(s)
Number of Incidents Reported
Injury, Illness, or Damage Reported
Root Cause of the Problem
How the Defect or Hazard Was Identified
Recall Actions Taken
Communication (How Notification Was Made to Consumers, Distributors, Retailers, etc.)
Corrective Actions Planned or In Place
Additional Comments or Details