Employee Communication Form (Salaried Employee)

Employee Communication Form - Salaried Employee

Please ensure all fields are completed before submitting
Today's Date*

MonthDayYear
Date
Employee Information
Location
Employee Name*

First NameLast Name
Employee ID*
Department*
Position/Title*
Supervisor Name*
Offense Information
Date of the offense*

MonthDayYear
Date
Date(s) of Offense
Verbal WarningWritten WarningFinal Written WarningSuspension (SPI)Termination
AttendanceAbsenteeismViolation of Safety RulesSubstandard WorkViolation of Company PoliciesRudeness to Customers/CoworkersDeadline/Deliverable MissedOther
Details of Offense*
Witness's *
Please enter the name of any witnesses that witnessed the violation/offense. If none please add N/A.
Action plan
YesNo
Please upload any supporting documents related to this disciplinary action

Ex: Screenshots, timecards, witness statements, reviews etc.
Cancelof
Supervisor Name: _________________________________________Title: ____________________________

Supervisor Signature: ____________________________________ Date: ____________________________

Wintess Name: ___________________________________________ Title: ____________________________

Witness Signature: ________________________________________ Date: ____________________________
By signing below, you confirm that you understand the information in this warning. You also confirm that you and your manager have discussed the warning and a plan for improvement. Signing this form does not necessarily indicate that you agree with this warning.
Employee Signature: ____________________________________ Date: ______________________

Employee refused to sign: ___________________________________________________________

Employee is unable to sign - Reason: ________________________________________________
Employee Statement:

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Should be Empty:

Employee Communication Form - Salaried Employee

Employee Information

Offense Information