This action might not be possible to undo. Are you sure you want to continue?
(Date of letter should be same date that the employee receives the letter.)
Mr./Ms. FULL NAME (FIRST AND LAST) - Include middle/nickname if necessary.
SUPERVISOR’S FULL NAME
DEPARTMENT NAME, CB# XXXX
Disciplinary Decision of Dismissal
Purpose of Notification
This letter is formal notification of my decision that, effective <DATE>, you are being dismissed from
employment due to your <Unsatisfactory Job Performance, Grossly Inefficient Job Performance,
Unacceptable Personal Conduct> specifically, for < … >.
Relevant Past Occurrences or Active Disciplinary Actions
<Note any past conversations with employee regarding this topic, including informal counseling
sessions. If there are any other active disciplinary actions, list them with a brief synopsis. Generally,
you can copy this section directly from what was included in the PDC letter.>
On <DATE> you and I met regarding (…) and I instructed you to (…)
2. On <DATE> you received an Informal Counseling Memo regarding unsatisfactory job
performance, specifically due to (…)
3. On <DATE> you received a Written Warning for unacceptable personal conduct,
specifically due to (…)
Incidents Resulting in This Disciplinary Decision
<Detail what events occurred, cite relevant policy as needed, ie, provide the specifics of the event, the
employee’s responsibilities in this event, and how these actions may violate University policy, fail to
meet work expectations, or are otherwise unacceptable. Generally, you can copy this section
directly from what was included in the PDC letter.>
2. <POINT #2>
3. <POINT #3>
4. <POINT #4>
Additional Information Provided at Pre-Disciplinary Conference
On <DATE> you attended a pre-disciplinary conference to discuss this issue. Also present at this
Conference were <NAME>, Employee & Management Relations Consultant from the Office of Human
Resources, and myself.
<Describe the course of events of the PDC; what questions were asked of the employee, what responses
were given, what questions the employee asked and responses given. Be specific. Whenever possible,
match the enumerated points from the “Incidents Resulting” section above.>
Office of Human Resources (for University Personnel File) Department Personnel File Page 2 of 2 .edu/.unc. If you have questions about your appeal rights. must be returned to the department at the time of separation. Employee’s Signature: _____________________ Date: ________________ Attachment: SPA Grievance Policy cc: NAME <Chair of the Department/Division> Dean’s Office <if required by Dean’s Office> Employee & Management Relations.2. badges. please contact the Grievance Coordinator in Employee & Management Relations at (919) 843-3444. as provided by University policy. you must submit your appeal to Employee & Management Relations in the University’s Office of Human Resources within 30 calendar days of receiving this disciplinary action. <Also indicate that keys.. <I find the allegations of harassment warranted. <POINT #2> 3. YOU ARE NOT REQUIRED TO INCLUDE THE ACKNOWLEDGEMENT LANGUAGE BELOW. Disciplinary Decision Based on all information provided regarding this issue.> Retention of Disciplinary Action and Public Access to Records This disciplinary action is being issued pursuant to the University’s Disciplinary Action Policy for SPA employees and will be retained as part of your permanent personnel file along with all related disciplinary action documents. Supervisor’s Signature Supervisor’s Signature: _____________________ Date: ________________ <NOTE: AN EMPLOYEE’S SIGNATURE IS NOT REQUIRED BUT IS RECOMMENDED. I find that you had sufficient training to complete the assigned tasks appropriately yet failed to do so. . For your convenience. etc. as required by law or State policy. etc.> Employee Acknowledgement I acknowledge that I have received this disciplinary letter. I find that you inappropriately used University resources in violation of University policy.. All applicable payouts of leave or earned time off will be made to you. effective <DATE>.> Therefore. Appeal Rights You have the right to appeal this disciplinary action under the University's SPA Grievance Policy. you also may obtain a copy of the SPA Grievance Policy through Employee & Management Relations or at the Office of Human Resources website at http://hr. <POINT #3> 4. Please be aware that North Carolina General Statute 126-23(a)(11) provides that dismissal letters are public information and must be released if requested. and any debts you may owe to the University will be deducted in your last paycheck. I understand that my signature below does not necessarily imply agreement with the disciplinary action taken. I have decided to dismiss you from your employment with the University. A copy of the Grievance Policy is attached. To be eligible.