Information
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Employee Name
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Manager
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Date
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Type of action
Body
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It has come to the attention of management that your recent actions are not in keeping with our company policies and values. This notification is to serve as official notice to inform you that this type of behavior will not be tolerated. Failure to make changes outlined will result in further action including but not limited to corrective action notices, reprimand notices, suspension, demotion, or termination. It is imperative that you take these notes seriously and make necessary changes as quickly as possible.
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Reason for issuing notice (Check all that apply)
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Pad policy violation (attach photo)
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Add media
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Poor customer service scores
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Excessive absenteeism
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Excessive tardiness
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Insubordination
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Under the influence of intoxicants
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Excessive use of telephone (this includes utilizing cell phones for social media, games, and other productivity inhibiting activities.)
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Taking too long for lunch/breaks
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Fighting
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Failure to follow instructions
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Profanity (explain)
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Explain
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Poor work performance
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Assault (Explain in detail)
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Explain the situation. Be sure to note any witnesses to the event and interview all present.
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Unauthorized removal of company, client, or co-worker property
Employee statement/acknowledgement
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By signing this form I acknowledge that I have received this notice and it has been discussed with me. I fully understand the reason for the notice and the issuing manager has addressed all my questions and concerns. I further understand that violating company policy is unacceptable and management is solely responsible for determining punitive action if deemed appropriate. By signing this notice you acknowledge receiving the notice only. Should you not agree with it you have the opportunity to state your case below.
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Employee Notes
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Supervisor Notes
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Employee
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Manager
