Title Page
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Lee Lewis Construction Disciplinary Action Report
EMPLOYEE DISCIPLINARY ACTION REPORT
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Date / Time
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Employee Name
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Employee Number
Violation
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Excessive Absences
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Tardiness
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Substandard Work
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Insubordination
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Disorderly Conduct
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Abuse of Equipment or Materials
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Violation of LLCI Rules
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Violation of Safety Rules
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Leaving Work Without Permission
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Harassment of Other Employees, Visitors, Etc.
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Substance Abuse Violation
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Attitude
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Unprofessional Conduct
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Falsifying Application
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Other
Action Taken
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Written Warning
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Second Written Warning
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Third Written Warning
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Termination
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Termination Effective Date
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Reason For Termination
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Investigative Suspension
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Investigative Suspension Beginning Date
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Investigative Suspension With Pay
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Investigative Suspension Without Pay
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If Unsubstantiated, Date Employee Returned to Work
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Disciplinary Suspension
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Disciplinary Suspension Number of Days
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Disciplinary Suspension With Pay
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Disciplinary Suspension Without Pay
Offense
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Explanation of Offense: State the Complete, Accurate, and Unbiased Facts. All Persons, Places, and Records Mentioned Should Be Properly Identified.
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Corrective Action Recommended
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Employee Remarks
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This Warning Will Be Made a Part of Your Employment Record. Continuation of the Behavior Identified Herein Will Subject You to Further Disciplinary Action, Up to and Including Termination.
Persons Involved
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Signature of Employee
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Signature of Supervisor
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Signature of Witness