/ AS9100 & AS9120 Corrective Action Request Form / Job No:
Organization: / Identification C.A.R. No.:
Site: / Date issued:
Reference Standard: / Referenced Standard Element concerned:
*Criticality
Ma / mi / Non-Conformance Description
*Major: The absence of, or total breakdown of a quality management system element specified in AS/EN 9100 and/or AS/EN 9120, or any non-conformities where the effect is judged to be detrimental to the integrity of the product, processes or service.
Minor: A single system failure or lapse in conformance with a procedure relating to AS/EN 9100 and/or AS/EN 9120.
Assessor Name: / Assessor Signature:
Assessed Organization to complete the Corrective Action Request with root cause analysis, correcting and corrective action and planned completion date of corrective action, and return to the assessing Company by duedate. Please use additional sheets as necessary / Due date:
Action No.: / *Root Cause (What was the root cause of the problem/how did it occur?) Please attach any analysis data:
Action No.: / Correction Action (What have you done to correct this specific problem?):
Action No.: / Long Term Corrective Action (What action have you taken to stop the problem happening again?): / Planned completion date of Corrective Action:
Organization Representative Name: / Signature: / Current date:
Verification of the implementation of the completed Corrective Action by the Client
Organization Representative Name: / Signature: / Current date:
Verification of the implementation of the completed Corrective Action to be filled out by the IMS Auditor
Verification date : / Accepted:
Yes r No r / Assessor Name : / Assessor Signature :
Verification Section for use by IMS Auditor (please document evidence of the verification of the closure of the non-conformances, use other pages if necessary)
Questions to ask yourself during the review: Is the Root Cause Effective? Has the client clearly defined the root cause to the problem? Have they performed sufficient root cause analysis?
Has the Immediate Corrective Action contained the situation? Has the client considered possible other effected products/parts/clients?
Has the Long Term Corrective Action solved the Root Cause? Will the Long Term Corrective Action prevent the non-conformance in future?

*Please see the IMS Website for guidance on Root Cause Analysis, other information is available, any CAR’s submitted without detailed root cause analysis will not be accepted and may prevent your certification being continued or issued.

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