EMPLOYEE:
*
DATE OF WARNING:
*
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Month
-
Day
Year
SUPERVISOR:
*
TYPE OF VIOLATION:
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Attendance
Tardiness
Carelessness
Disobedience
Safety
Work Quality
Other
WARNING:
Violation Date
*
-
Month
-
Day
Year
1. Employer Statement
Enter details of violation.
*
2. Employee Statement
Enter comments.
*
3. Warning Decision
Enter decision.
*
I declare that to the best of my knowledge the information I have given in this statement is correct and complete
*
I Agree
Date Employed From
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Day
-
Month
Year
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Signed:
*
Supervisor Signature
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Supervisor Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
4. Employee Acknowledgement
I acknowledge that I have read this warning decision, I understand it, and have received a copy of the same.
*
I Agree
Signed:
*
Supervisor Signature
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Employee Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
E-mail
*
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