Legal Employment & Labor Disciplinary Action Form
Legal Employment & Labor Disciplinary Action Form
Complete this form in its entirety to document any disciplinary action taken against an employee for violating [Your Company Name] policies or procedures. Ensure all sections are filled out accurately and that both the employee and supervisor sign the form to acknowledge understanding and receipt.
EMPLOYEE INFORMATION
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Employee Name: |
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Employee ID: |
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Department: |
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Position: |
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Date Hired: |
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Supervisor: |
INCIDENT INFORMATION
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Date of Incident: |
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Location of Incident: |
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Witnesses: |
NATURE OF THE VIOLATION
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Type of Violation: |
☐ Attendance ☐ Tardiness ☐ Insubordination ☐ Policy Violation ☐ Performance ☐ Misconduct ☐ Other (please describe): |
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Description of Violation: |
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Reference to Company Policy/Rule Violated (if applicable): |
PREVIOUS DISCIPLINARY ACTION
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Have there been any previous disciplinary actions for this type of violation? |
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If yes, provide details (include dates and types of actions): |
CURRENT DISCIPLINARY ACTION
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Action Taken: |
☐ Verbal Warning ☐ Written Warning ☐ Suspension (with or without pay) ☐ Demotion ☐ Termination ☐ Other (please specify): |
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Effective Date: |
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Details of Action Taken: |
Employee Acknowledgment:
I acknowledge that I have received and understand this disciplinary action. I understand what is expected of me in terms of improvement and the consequences of failing to meet these expectations.
Employee Signature:
Date: [Month, Day, Year]
Supervisor Signature:
Date: [Month, Day, Year]
HR Department Signature:
Date: [Month, Day, Year]
