Sample of Sample of Notice of Disciplinary Action

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Sample of Sample of Notice of Disciplinary Action Powered By Docstoc
					       Sample of Notice of Disciplinary Action
Employee Name: __________________________          Date: ____________________
Department: ______________________ Supervisor Name: ___________________
Has the employee been previously counseled or disciplined for same or similar
reason?             No               Yes - Date _______________
Documented?           No                 Yes - Date ________________
The reason/event/cause for this Disciplinary Action is the following:




The following Company rule/policy applies:
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If this situation is not corrected, the next step will be:
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Employee Comments:
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_____________________________________________________________________
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Employee's signature indicates receipt of report only, not agreement with content.


Employee Name: _____________________________

Employee Signature: __________________________

Supervisor Signature: _________________________          Date: ________________