Employee Written Warning Written Employee Notice Employee Name Date by shellto1

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									                                    Written Employee Notice




Employee Name:                                                           Date:

   Department:                                                Date of Incident:


  1) Has the employee received a verbal warning?        Yes ☐            No ☐


  2) Type of Warning.           First Warning ☐                Final Warning ☐


  3) Why is this warning being given? Check all that apply



       Tardiness                         Failure to give timely                Timecard/time clock
                                           notification of absence                violation

       Excessive absenteeism             Safety violation                      Unauthorized overtime



       Poor job performance              Insubordination                       Under the influence of
                                                                                  drugs/alcohol

       Personal                          Sexual harassment                     Intentional or negligent
        business/conversation                                                     damage to company
        during work                                                               property
       Physical or verbal                Unauthorized removal of               Failure to get along with
        assault/fighting                   company property                       fellow employees




  4) Describe in detail the employee’s specific rule violation or conduct problem.
     ______________________________________________________________________________
     ______________________________________________________________________________
     ______________________________________________________________________________

  5) Describe changes the employee is expected to make.
     ______________________________________________________________________________
     ______________________________________________________________________________
     ______________________________________________________________________________
    6) Describe the consequences if changes are not made by the employee.
       ______________________________________________________________________________
       ______________________________________________________________________________
       ______________________________________________________________________________



    7) Employee statement or rebuttal (if applicable).
       ______________________________________________________________________________
       ______________________________________________________________________________
       ______________________________________________________________________________


                              TO BE READ AND SIGNED BY THE EMPLOYEE:

The above problem(s) have been discussed with me, and I understand that failure to improve my
performance or additional unsatisfactory behavior will result in further disciplinary action, up to and
including suspension or termination. I understand that my signature does not necessarily signify
agreement with the facts or actions stated. If I disagree, it is my option and responsibility to pursue an
appeal.




_______________________________________________________                            ___________________
Employee Signature                                                                 Date




_______________________________________________________                            ___________________
Supervisor Signature                                                               Date

								
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