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disciplinary notice

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					                               DISCIPLINARY NOTICE

Employee Name:                                                 Department:

 Counseling       Verbal Warning        Written Warning        Notice of Suspension        Termination

1.      Statement of violation (violation of rules, policies, standards, practices or unsatisfactory
        performance):



2.      Prior discussion or warnings on this subject (applicable dates etc):



3.      Statement of company policy on this subject:



4.      Summary of corrective action plan (include dates for improvement and plans for follow-up):




5.      Consequences of failure to improve performance or correct behavior (further disciplinary action;
        termination):



6.      Employee comments:




        Employee’s Signature               Date            Supervisors Signature                   Date

 Employee Refusal to Sign (check this box if applicable)

********************************************************************************************
Notes: If the situation requires it, please attach further written explanation on a separate page .Then
proceed as follows:

Distribution:   One copy to Employee, one copy to Supervisor and original copy to Personnel File
Confidential                               Page 1                                     8/15/2008

				
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Description: This is an example of disciplinary notice. This document is useful for conducting disciplinary notice.