Owner Name Title Signature Date Kathy Curtis Supplier Quality Engineer ON FILE ON FILE Approvals Name Title Signature Date ON FILE ON FILE Dan Madsen Quality Manager ON FILE ON FILE Rich McKusick Materials Manager Change Control Training Changed Description of Change Date Required? Revision By Y / N Original, for supplier deviation Deviation requests. Former “Exlar A Y 08/08/2016 KAF / KPC Reference procedure is SOP 32076. Form”, Form 32078 Rev B. 1. Documentation Control
Owner Name Title Signature Date Kathy Curtis Supplier Quality Engineer ON FILE ON FILE Approvals Name Title Signature Date Dan Madsen Quality Manager ON FILE ON FILE Rich McKusick Materials Manager ON FILE ON FILE Change Control Revision Description of Change Training Required? Y / N Date Changed By A Original, for supplier deviation requests. Former “Exlar Deviation Form”, Form 32078 Rev B. Reference procedure is SOP 32076. Y 08/08/2016 KAF / KPC 1. Documentation Control
70529_Rev-A_Supplier-Deviation-Request-Form_20160809.docx