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Disciplinary Committee Action Form

This document is a disciplinary committee action notice for an employee of Ashton Apparel Manufacturing. It lists possible violations an employee could commit and actions the company could take in response. This specific notice is for an employee who committed an infraction but the details are redacted. It documents the offense, discussion with the employee, recommended corrective actions, and gets signatures from the employee and their supervisor.

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0% found this document useful (0 votes)
555 views1 page

Disciplinary Committee Action Form

This document is a disciplinary committee action notice for an employee of Ashton Apparel Manufacturing. It lists possible violations an employee could commit and actions the company could take in response. This specific notice is for an employee who committed an infraction but the details are redacted. It documents the offense, discussion with the employee, recommended corrective actions, and gets signatures from the employee and their supervisor.

Uploaded by

abawaka3
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Form No.

HRS/036-1
Date ________

Ashton Apparel Manufacturing P.L.C


Disciplinary Committee Action Notice

Employee Name: ___________________________________ Department: _____________________ Date: ________________

VIOLATION:
[ ] Excessive Absences [ ] Substance Abuse violation [ ] Attitude
[ ] Tardiness [ ] Unprofessional conduct [ ] Patient Abuse
[ ] Substandard Work [ ] Clock –in/out violation [ ] Abuse of equipment of materials
[ ] Insubordination [ ] Violation of safety rules [ ] Violation of Confidentiality
[ ] Disorderly Conduct [ ] Leaving work without permission [ ] Other _____________________

ACTION TAKEN:
[ ] Verbal Warning [ ] Investigative Suspension (beginning __/ __ / __)
[ ] Written Warning [ ] With Pay [ ] Without pay
[ ] Second Written Warning If unsubstantiated, employee returned to work __ / __/ __
[ ] Termination (effective __ / __ / __) [ ] Disciplinary Suspension ____ days (__ / __ / __ - __ / __ / __)
[ ] With Pay [ ] Without pay

EXPLANATION OF OFFENSE: Record complete, accurate, and unbiased facts. All persons, places, and records mentioned
should be properly identified. Use additional page if necessary.

DISCUSSION _______________________________________________________________________________________________

____________________________________________________________________________________________________________

___________________________________________________________________________________________________________

CORRECTIVE ACTION RECOMMENDED ______________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

EMPLOYEE’S REMARKS ____________________________________________________________________________________

___________________________________________________________________________________________________________

___________________________________________________________________________________________________________

This warning will be made a part of your record. Continuation of the behavior identified herein will subject you to further disciplinary
action, up to and including termination.

_________________________________________________ __________________________________________________
Signature of Employee Date Signature of Supervisor/Counselor Date

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