Record of Disciplinary Action

Employee Name Employee Title

Manager Name Manager Title
Today’s Date Incident Date
Incident Time Incident Location

Description of the incident that occurred:

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Witnesses to the incident (if applicable):

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Names of those in attendance at current disciplinary action meeting:

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Corrective or disciplinary action to be taken:

 Verbal  Written  Probation  Suspension  Other (explain below)
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(If on probation, period begins ___________________ and ends ___________________.)

Goals to be Achieved:
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Consequences for failure to improve performance or correct behavior:

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Tham khảo các loại biểu mẫu và mẫu đơn khác tại trang web http://www.kinhdoanh.com/.
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Prior discussions or warnings on this subject, whether oral or written:

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Employee statement:
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I acknowledge that I have read and understand the above information and consequences.

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Employee Signature Ngày

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Supervisor Signature Ngày

Tham khảo các loại biểu mẫu và mẫu đơn khác tại trang web http://www.kinhdoanh.com/.