Form P8-01
Company XYZ                                  REWORK FORM
                                                                            Page 1 of 1
Issued on:                     Version No: 1                           Revised:
Issued by:                     Supersedes:
Date: _________________________
                                   Rework Work Sheet
                                                                                                               Product In Production: _______________                
           Materials being reworked and Source                                      
                  Lot Code of Rework materials                                      
                    Lot Code of products (new)                                      
                    Qty of rework material used                                     
                      Qty of products produced                                      
               Allergen present in raw materials                                    
                   Allergen present in products                                     
       Approval of rework materials to be used                                      
                                                                                    
Quality Assurance Manager:_____________________________          Date: ________________