Supplier Corrective Action Request (SCAR) Form

SCAR Number Date Issued
Reference/PO Number Due Date for Response
Supplier Name Supplier Contact
Product ID/Part Number Product Description
1. Problem Description (Detail the issue/defect detected)
2. Background/Supporting Data (include photos, test results, lot numbers, etc.)
3. Immediate Containment Action (What was done to address affected materials?)
4. Root Cause Analysis (Describe investigation and findings)
5. Corrective Action Plan (Include actions, responsible person(s), and implementation dates)
6. Verification of Effectiveness
SCAR Initiated By Date
Supplier Responsible Date
Reviewed/Closed By Date