Free Disciplinary Action Form HR Template

DISCIPLINARY ACTION FORM

Employee's Name: [Name]

Department:

Investigator's Name: [Your Name]

Date: [Date]

Nature of Violation:

  • Tardiness/Absenteeism

  • Insubordination

  • Violation of Company Policy

  • Poor Performance

  • Misconduct

  • Other (Specify): ____________________________

Investigation Details: ____________________________________________________________

Previous Incidents or Warnings:

Incident Date: __________

Description: ______________________________________________________________________

Disciplinary Action Taken:

____________________________________________________________________________________

Employee Acknowledgment:

I, [Name], acknowledge that I have received this Disciplinary Action Form and understand the actions taken against me. I have had the opportunity to provide my response to the incident, and I have been informed of the consequences of this disciplinary action.

Employee Signature: ______________________

Date: [Date]

Supervisor's Comments: ___________________________________________________________

Supervisor's Signature: ______________________

Date: [Date]

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