Information
Employee Disciplinary Warning
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Employee Name:
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Employee Number (if available):
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Division:
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Date:
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Manager / Supervisor:
Employee Information:
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Employee Name:
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Employee Number (If Available):
Incident Information:
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Incident Date:
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Previous Warning?
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Previous Warning Date:
Reason for Warning:
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Rules Violation?
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Violation of Work Rules:
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Describe Violation:
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Violation of Company Policy:
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Describe Violation:
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Violation of Safety Rules
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Other:
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Describe Violation:
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Attendance Violation?
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Excessive Absence:
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Describe:
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Excessive Tardiness or Leaving Early:
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Describe:
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Other:
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Describe:
Type of Warning:
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Verbal Warning:
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First Written Warning:
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Second Written Warning:
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Final Written Warning:
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In order to avoid further disciplinary action, the following steps must be taken:
Comments:
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Supervisor Comments:
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Employee Comments:
Disclaimer:
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I acknowledge that the disciplinary process and format of this form were explained in Low German, and, I fully understand the conditions stated.
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Employee Initials:
Signatures:
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Employee Signature:
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Date:
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Supervisor Signature:
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Date:
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Manager Signature:
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Date:
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Human Resources Signature:
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Date:
