Hold / Rework Form

First Name PhoneDate Part #Initial Part Name Shift 1 2 3

Lot #Operation

Forging Hobbing Drill Cell Hard turn BushingSoft Turn Deburr/Marking Heat Treat Grinding Assembly

Describe in detail reason parts are suspect:

sortrework

Name scrapPhone otherDate

MRB comments:

Part # Lot #

Hours

Total Hours Accepted Total Rejected Total

Operations Date

Quality Date

Last Name

Other

Piece Count

Total Parts AcceptedRework / Sort

Operation

Rework/Sort Instructions

Scrap

Quantity

Disposition Authorization

Rejected InitialDate (month-day-year)

Final Approval

SignedDateScrapped Lot #

3-19-13 Rev: Original Form # 0480

Hold / Rework Form

Hours

Crank Rework / Sort (continued)

Operation Date (month-day-year) Total Parts Accepted Rejected Initial

3-19-13 Rev: Original Form # 0480