Supplier contact names: List the name of the core team members (name and title):
Supplier Name Part Number DUNs/Location Product/Process Name Date of Occurrence
Problem Definition:
(who,what, when where and
how)
3 Legged 5 Why Picture of Current State Corrective Actions / Owner / Target Date Picture of corrected state
Problem Description: Intermediate Containment: please list Owner and Target Date:
How problem was created
Why:
Final Permanent Corrective Action:please list Owner and Target
Date:
Why:
Why:
Problem Description: Intermediate Containment: please list Owner and Target Date:
Why problem was not detected?
Why:
Final Permanent Corrective Action:please list Owner and Target
Date:
Why:
Why:
Why:
Problem Description:
What is the Systemic root cause?
Why:
Why:
Why:
Why:
Look Across Requirements: Within the Occurred Plant Other Plants/Suppliers Others
Covisint Problem Case Number Affected Nexteer Locations: Supplier Location: City/State/Country Nexteer Contact Name and Phone: