Change Control Request Form
Document No Version # Issue Date
Page 1 of 3
OMS/IMS/SOR-030 02 24-10-2019
Request No. (Allotted by IMS Head) C C R ─ 0 0 1
To be filled by Initiator
Request Initiator Name: Request Initiator Designation:
Initiator Department: Request Initiate Date:
To be filled by Compliance Specialist
Change Required: Yes No
Remark if any:
______________________________________________________________________
______________________________________________________________________
______________________________________________
Change Evaluation/ Assessment:
Description of Change: (To be filled by Relevant Initiator/ Departmental Head)
Change Control Request Form
Document No Version # Issue Date
Page 2 of 3
OMS/IMS/SOR-030 02 24-10-2019
Product/ Process Infrastructure Machinery/ Equipment
Dismantling/Removal Technological Other Please specify
Details:
Reason for Change: To be filled by Initiator/ Relevant Departmental Head
(Justify why the proposed change should be implemented)
Resources and Skills required to make change: (To be filled by Initiator/ Relevant
Departmental Head)
How does the proposed change affect the IMS? (Detail about Impact of suggested
change) To be filled by IMS Coordinator and IMS Department
Change Control Request Form
Document No Version # Issue Date
Page 3 of 3
OMS/IMS/SOR-030 02 24-10-2019
Resulting Changes (to existing IMS procedures, Inspection and testing method,
Process / Infrastructure/ Document / Drawings, Training requirements, Risk
Assessment, Legal Requirement etc.)
Change Control Request Approval: (To be filled by Managing Director)
Approval Date Name Signature Recommendation
Approved
Rejected
Deferred
Monitoring of Implemented Change (if required) & Closeout
Date of Change
Name (Compliance Specialist) Signature
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