Employee Warning Notice

Employee Warning Notice
Employee Name ______________________________________ Date of Warning _______________
Employee Payroll # __________________ Department _______________ Shift _______________
1. Type of Violation
Attendance Tardiness or early quit
Failure to follow instructions Carelessness
Unsatisfactory work quality Working on personal matters
Violation of safety rules Willful damage to material or equipment
Rudeness to employees or customers Violation of company policies or procedures
Other
2. Previous Warnings
Oral
Written
Date
By whom
1st Warning
2nd Warning
3rd Warning
3. Employer Statement
Date of Incident ___________________________________________ Time __________________________
4. Employee Statement
I agree with Employer's Statement.
I disagree with Employer's description of violation for these reasons:
5. Action(s) to be taken
Warning Probation Suspension Dismissal Other
Consequence should incident occur again
________________________________________________________________________________________
6. Notice acknowledgment
I have read this Empoyee Warning Notice and understand it.
Signiture of employee
Signiture of supervisor who issued warning ___________________________________
(Rev. 08/03) f.x.hr.wa
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