Ref :

Salim & Brothers Group

Incidents Reporting and Product Issue No.
A/3 BSCIC Industrial Area,
Rev. No.
Sagarika Road, Chittagong, Recall Effective Date :
Bangladesh

Date :

From : Salim & Brothers Group.

To : M/s.__________________________________________________________

Customer notification form

Dear Customer,

We require your to immediately examine existing inventory and segregate the following product and return
to us as soon as possible.
1) Product (s)

2) Size (s)

3) Date of shipment

4) PO number

5) Style ref. No.

6) Invoice No.

7) Quantity

8) Packages nod. (from / to)

We have recently identified that the above products may show a deficiency. The deficiency is "________

______________________________________________________________________________".

Hence, we ask you to assist in removal of these products from distribution / stores / warehouse.
First we request you to review our products from inventory and segregate and hold all products meeting
the above reference details.

Second we will contact your to arrange for retrieval of the product and arrangements shall be made to
replace the defective products.

Please call us immediately at phone number : Salim & Brothers Group._______________________to confirm
that You have received the notice

Thanks for your co-operations,

For __________________

Authorized Signatory

Prepared by: Approved by:

"CONTROLLED COPY"
Quality Assurance Manager General Manager