Deviation Request Form
Supplier Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Part Information
Part number
Description
Revision level
Purchase order number
The number of parts effected
Deviation Information
Deviation request
Part related
Process related
First time request
Repeat issue
Permanent
Temporary
Other
Indicate the characteristic, the requested deviation value, and the proper units
Reason for deviation
Identify corrective action taken to prevent similar deviations in the future
Identify preventative action necessary to prevent similar deviations in the future
Approval of Company Responsible Person
Name
First Name
Last Name
Situation of deviation
Approved
Denied
Conditional
Conditions/restrictions for use of deviated material
Reason for rejection
Signature
Submit
Submit
Should be Empty: