Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
GENERAL INFORMATION
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Complete thoroughly and accurately. Send copy to Employee, Human Resource Manager, Supervisor and self.
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Employee Name:
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Employee Social Security Number:
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Employee Location/Route Number:
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Warning Date:
TYPE OF VIOLATION
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- Attendance/Tardiness
- Rudeness/Poor Customer Service
- Unsatisfactory Work Performance
- Gross Misconduct
- Violation of Company Policy or Procedures
- Insubordination
- Failure to Follow Instruction
- Working on Personal Matters
- Other
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Additional Comments:
PREVIOUS WARNING INFORMATION
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1st Warning
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- Oral/Verbal
- Written
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Warning Date:
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Warned By Whom:
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2nd Warning
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- Oral/Verbal
- Written
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Warning Date:
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Warned By Whom:
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3rd Warning
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- Oral/Verbal
- Written
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Warning Date:
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Warned By Whom:
EMPLOYER STATEMENT
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Employer Details of Incident:
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Date & Time of Incident:
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Supervisor:
EMPLOYEE STATEMENT
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Employee Details of Incident:
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- I agree with Employer Statement
- I disagree with Employer Statement
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Employee:
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Date & Time:
ACTION TAKEN
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- Warning
- Probation
- Suspension
- Dismissal
- Other
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Additional Comments on Action Taken:
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Consequence Should Incident Occur Again in Future:
SUMMARY
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I have read this employee warning notice and fully understand it.
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Employee Signature:
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Date & Time:
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Supervisor Signature:
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Date & Time:
