QA signoff for a software application

As a part of the QA job, we need to send a sign off document. for this we send the details about the feature/release and the testing overview. Generally there is no any specific format for this, still I found a template for this.
This help me to do my job in a effective way.
here is the formate :

QA SIGN-OFF

For Project: Project name [eg. Radio Mini]
Feature: Feture or module name [eg. RSS-Feed]
Project Team: Team name ( eg. PA core team)
Dev Team Members: Name of the developers who are involved in developing this feature or module. eg.
• [Santosh Singh]
• [Ekta Singh]
• [Gurpreet Singh]
Extended Team: list out the members if applicable ( manpower from other project who are involved in this work)
Submitted for testing on: Date on which feature handled for testing [dd/mm/yyyy]
Tested by: Testing team member(s) name (eg. Vishal Sachan )

Proof of Compliance: list out all the documents which need to send for your proof. eg.
Testing Checklist – [File Name]
Test Results attached- [File Name]

Testing Overview: mention here the activity you performed for your testing. what kind of testing, what methodologies u applied etc. eg.
Manual Web UI.
Ran all possible test cases.
Held open testing with team members.


Sign-Off Section:
This system conforms to QA requirements. Finally it is done. I am signing off the feature (RSS-Feed) on the version alpha1.2 of peepagg.net and on its child project Radio Mini.

Hope this will help you. please give your feed back.



Reference:
http://www.mun.ca/cc/systemdevelopment/content/appendixa/qa_evaluation_template.pdf