TO :

FROM : THE HUMAN RESOURCES & DEVELOPMENT DEPARTMENT

SUBJECT : (State the offense)

DATE :

NOTICE OF GRAVE OFFENSE

Pursuant to our Employee Manual and Code of Professional Conduct, Discipline and Work
Efficiency, Section _______ (page __) and Section _____ (page __) states that:
“__________________________________________________________________________;”
is a grave offense punishable by ______________.

In view of such, you are hereby given forty-eight (48) hours; upon receipt of this notice, to
explain why a disciplinary action should not be imposed on you for the following grave offenses:

 That on _______________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_;

After you submit your letter of explanation, an investigation and conference/hearing will be
conducted to further give you an opportunity to explain and clarify your actions. Your failure to
explain within forty-eight (48) hours means that you are waiving your right to due process and
that management has the right to implement the appropriate sanction.

HRD Manager

ACTC-FR-041 Rev. 00