Title Page

  • Lee Lewis Construction Disciplinary Action Report

EMPLOYEE DISCIPLINARY ACTION REPORT

  • Date / Time

  • Employee Name

  • Employee Number

Violation

  • Excessive Absences

  • Tardiness

  • Substandard Work

  • Insubordination

  • Disorderly Conduct

  • Abuse of Equipment or Materials

  • Violation of LLCI Rules

  • Violation of Safety Rules

  • Leaving Work Without Permission

  • Harassment of Other Employees, Visitors, Etc.

  • Substance Abuse Violation

  • Attitude

  • Unprofessional Conduct

  • Falsifying Application

  • Other

Action Taken

  • Written Warning

  • Second Written Warning

  • Third Written Warning

  • Termination

  • Termination Effective Date

  • Reason For Termination

  • Investigative Suspension

  • Investigative Suspension Beginning Date

  • Investigative Suspension With Pay

  • Investigative Suspension Without Pay

  • If Unsubstantiated, Date Employee Returned to Work

  • Disciplinary Suspension

  • Disciplinary Suspension Number of Days

  • Disciplinary Suspension With Pay

  • Disciplinary Suspension Without Pay

Offense

  • Explanation of Offense: State the Complete, Accurate, and Unbiased Facts. All Persons, Places, and Records Mentioned Should Be Properly Identified.

  • Corrective Action Recommended

  • Employee Remarks

  • 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

  • Signature of Employee

  • Signature of Supervisor

  • Signature of Witness

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