No.	rev
Requested by:	Date:
Doc. Title:	DOC #:
Multiple Documents (see description)	Current Revision:	New Revision:
The originator is required to complete the blue sections	The red sections are completed only by Document Control

Reason for change and brief description of the change:

Printed Materials Inventory:	N/A	Scrap	Use as-is	Rework	Other:

Approvals: (Select the appropriate personnel from the affected division / departments)

Name of Approving Employee	Initial / Date (if not electronic)

Document Owner

Quality Assurance

PCB Management

General Manager

Engineering Manager

Sales

Marketing

Product Manager

HR / Finance

Logistics

Production

ISP Manager

Training Required:	Affected Departments per Document	Manager(s)	Division wide

PCB Distribution Required?	Yes	No	Document Group(s):

Update LMS?	Yes	No

Status:

Approved

Clerk:	Received:	Notification Sent

Completed and posted / filed

Emailed to LMS