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Safety Case RRPart/material No.Part/material nameAuthorStatusDocument No.Project NoProject nameOwnerDoc typeDoc partVersionProduct groupCustomerDocument descriptionSafety CaseReview Record1 Table of Contents1Table of Contents22Revision History33Introduction44Review information44.1XXX Work Product subject for review44.2Review type44.3Review participants45Review conclusion56Review checklist56.1XXX Work Product independent checks56.2XXX Work Product dependent checks57Review remarks62 Revision HistoryVersionECN no.Changed byChange from last version01The change history shall be a detailed enough description of what sections that have been changed since the last version. Depending on the changes that have been made it may be necessary to describe the changes more in detail.Blue text in italic is information/explanation directed to the issuer of the document.Before releasing the Work Product (document) all blue italic text must be removed.Mark unused sections of this document as “NOT APPLICABLE”, do not remove the paragraph heading.Text marked with a is to be replaced by something specific. This shall be used if there are specific keywords within standardized paragraphs that shall be replaced when creating the Work Product from the template.3 IntroductionThis section is filled in when all review remarks have been closed and the moderator has approved the object under review, or a new review has been performed without remarks.Released revision of the XXX Work Product subject for review, (after applicable updates):Date of final approval:Moderator signature:4 Review information4.1 XXX Work Product subject for reviewName of the XXX Work Product subject for review:ID and revision of the XXX Work Product subject for review:Author of the XXX Work Product subject for review:4.2 Review typeType of review(mark with X)Internal review (XXX only)External review (XXX + customer and/or supplier)SpecifyReview methodOther4.3 Review participantsNameRoleModerator:Project ManagerReviewer(s):Project ManagerSystem Design ResponsibleSystem DesignerHardware ResponsibleSoftware Responsible5 Review conclusionDecisionDescriptionActions neededSatisfied Cosmetic or no remarks. No changes required. None.Action due dateConditionally satisfied Unclear issues.Minor improvements and clarifications necessary. New review is not required. Updates required. A new review is not required. Updates are to be approved by the moderator.Not satisfied At least one requirement is not met. Major improvements and clarifications necessary. New review is required. Updates required. A new review is required.6 Review checklist6.1 XXX Work Product independent checksItems to checkYesNoIs the XXX Work Product that is subject for review, and all referenced objects, placed under configuration control?Is the XXX Work Product that is subject for review, and all referenced objects, saved in a non-editable state?Have all relevant roles been invited to the review?Has sufficient time been allocated for performing the review?Have the review participants submitted review remarks prior to the review meeting?6.2 XXX Work Product dependent checksItems to checkYesNoHave all Work Products that have been listed as to be performed in the Safety Plan been performed?Have all Work Products that have been listed as to be performed in the Safety Plan been approved?Has the development been performed in accordance with the Safety Plan?Have all confirmation measures defined by ISO26262 part 2 chapter 6.4.71 been performed as specified?7 Review remarksActionFollow upNoOriginatorComments or remarkNoYesResponsibleAction approved (sign)123456789101112131415Form No: 1000718126 v02All information contained herein is confidential and/or proprietary to XXXXX and any unauthorized disclosure or utilization is expressly prohibi
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