Disciplinary Action Form HR
DISCIPLINARY ACTION FORM
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Employee's Name: [Name] |
Department: |
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Investigator's Name: [Your Name] |
Date: [Date] |
Nature of Violation:
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Tardiness/Absenteeism
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Insubordination
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Violation of Company Policy
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Poor Performance
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Misconduct
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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]
