Annexure 9 - Disciplinary Inquiry Form
Sasol
Confidential
For use by Employee Relations only
DATA BASE DATA BASE
INFORMATION REFERENCE
Verbal Warning
APPLICABLE FOR 4 EXPIRY DATE
Written Warning
MONTHS
APPLICABLE FOR 6 CLASSIFICATION
Serious Warning
MONTHS
Final Written Warning INITIAL O DA LR
APPLICABLE FOR 8
X MONTHS
Charge 8.3 c
X Charge 8.3 d
Final Written Warning with two
APPLICABLE FOR 12
weeks Suspension without
MONTHS after acceptance
remuneration (as alternative to
by employee in writing
Dismissal)
Suspension from _/ 20 ; to /_ /20_ _(totalling 2 weeks without remuneration)
DISMISSAL ALTERNATIVE SANCTION PROPOSED BY OFFENDER
EMPLOYEE'S NAME CN
DESIGNATION DIVISION
DATE OF MISCONDUCT
DESCRIPTION OF MISCONDUCT: (WHO, WHAT, WHERE, WHEN, HOW, WHY)
Document number Revision number Page number
HR RP ER SA 302 5 Date Printed: 14/09/2018 09:41:20 45 of 52
GENERAL: TOTAL DISCIPLINARY RECORD
DATE OF EMPLOYMENT
MITIGATING CIRCUMSTANCES AS PRESENTED:
AGGRAVATING CIRCUMSTANCES AS PRESENTED:
ADDITIONAL REMARKS BY CHAIRPERSON (add pages to Annexure 9 for detailed reasons):
It is admirable that the transgressor immediately took accountability of his actions, and displayed deep remorse for this
incident that occurred.
SIGNATURES
ISSUED BY
(CHAIRMAN)
NAME/ CO NUMBER DESIGNATION SIGNATURE
(IN BLOCK LETTERS
I HEREBY ACKNOWLEDGE THE WARNING TO REFRAIN FROM REPEATING ABOVEMENTIONED MISCONDUCT
I HEREBY ACKNOWLEDGE THE REASON/S FOR MY DISMISSAL
IN CASE OF SUSPENSION, I HEREBY AGREE TO THE SUSPENSION BEING WITHOUT REMUNERATION
EMPLOYEE
SIGNATURE CN DATE
REPRESENTATIVE
SIGNATURE CN DATE
HUMAN RESOURCES
SIGNATURE DESIGNATION DATE
Document number Revision number Page number
HR RP ER SA 302 5 Date Printed: 14/09/2018 09:41:20 46 of 52