DELPHI DELCO ELECTRONICS SYSTEMS
DE FOR 914.01A
5-Phase Corrective/Preventive Action Report
Effective Date: February 13, 2000
Content Reviewed Date:
February 8, 2000
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Delphi Delco Electronics Systems
5-Phase Corrective/Preventive Action Report
Initiated By:
Phone No:
Report No.
Issue To:
Requested By:
Initiation Date/Time:
Date Issued:
Date Found:
Assembly Plant:
Customer Name:
Platform:
Customer Complaint Information:
Reference Number:
Customer Tracking Number:
Model Year:
Product Family:
End Mode/Part Number:
Product Description:
Service Number:
Build Date/Date Code:
Problem Observed At:
Pager:
Bar/Lot Code:
RMA No:
Quantity:
Return Locn:
Problem Definition:
Responsible:
Completion Date:
Immediate Fix (Containment/Short Term Corrective Action):
Responsible:
Response Date:
Target Date:
Implementation Date:
Root Cause: (Should include a thorough investigation of why the problem occurred [5 Whys, Shainin methods,
etc.])
Responsible:
Response Date:
Completion Date:
Corrective Action: (Should include error-proofing and be implemented in all areas to which it applies.)
Break in Date Code:
Responsible:
Response Date:
Target Date:
Implementation Date:
Verification:
Plan:
Responsible:
Response Date:
Results:
Target Date:
Actual Date:
Accepted/Rejected:
Accepted/Rejected By:
Date:
5 Phase Closed By:
Date Closed:
DELPHI DELCO ELECTRONICS SYSTEMS
DE FOR 914.01A
5-Phase Corrective/Preventive Action Report
Revision Record
Effective Date: February 13, 2000
Content Reviewed Date:
February 8, 2000
Page 1 of 1
Reason for Revision
Date of Revision
Person Responsible

Initial release as DE FOR 914.01A
February 13, 2000
John E. King

Form was DE FOR 914.02A. It was renamed upon
deletion of DE 914.02 – Initial Release under this
number
Minor modifications to align with verbiage of IRIS
SRs.
