Requester
Name:	SCAR reference #:

Monitoring of dates	Non conform Parts received	Containment Actions implemented	Root Cause identified	Corrective Actions implemented	Preventive Actions implemented
Date
Failure description from customer including part reference:
Containment Action(s):	Responsibility (name)	Date of implementation
Add containment actions here e.g. 100% goods outgoing check, sorting at customer, repair, rework, etc. If there is more than one containment action add more lines. Only one containment action per line! Add information of first batch, serial number, etc. shipped with containment effective.
Root Cause(s):	Responsibility (name)	Date of identification
Add root cause(s) here. If more than one root cause add more lines. Only one root cause per line! Add 5 WHY and/or Fishbone diagram for each root cause.
Implemented Corrective Action(s)	Responsibility (name)	Date of implementation
Define implemented corrective actions (one per line), add information about verification, validation, possible side effects and add information about objective evidence, that corrective action is effectively solving the root cause as well as of implementation (reference papers like work instructions, FMEA extract, quality control plan, etc.). First batch, serial number produced with corrective action implemented.
Preventive Action(s)	Responsibility (name)	Date of implementation
Define implemented preventive actions (one per line), add information about verification, validation, possible side effects and add information about objective evidence, that preventive action is effectively solving the root cause as well as of implementation (reference papers like work instructions, FMEA extract, quality control plan, etc.). First batch, serial number produced with preventive action implemented.