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EMPLOYEE'S VERIFICATION OF DISCIPLINARY ACTION (RL-546) by 5w73VgGG

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									FORM RL-546

08-01-08

                   WEST VIRGINIA DEPARTMENT OF TRANSPORTATION

                      EMPLOYEE’S VERIFICATION OF DISCIPLINARY ACTION




              I,                                 , have been given an opportunity to

      meet with                                    personally or present a written

      explanation concerning the charges against me.



                               Summary of Employee’s Remarks :




           (Employee’s Signature)                       (Agency Representative)




                      (Date)                                     (Date)

								
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