Employee Warning Notice

Employee Name *

Job Title *

Department

Employee Supervisor *

Form Completed by

Type of Warning *

First WarningSecond WarningFinal Warning

Type of Offense *

TardinessAttendanceViolation of Company PoliciesViolation of Safety RulesPerformanceRudenessOther (See Below)

Other

if applicable

Statement of offense

Corrective action to be taken

Performance Improvement PlanImmediate Termination

I understand that checking this box constitutes a legal signature. I agree to be legally bound by this digital signature. *

I understand

Today's Date *

First and Last Name *

Birthdate *

Social Security Number *

Employee Response *

I understand and agree to adhere to the corrective action above. I agree that if another instance of this problem occurs during an outlined probationary period, Mike Scott Pluming can take all necessary actions in response including termination of my employment.I do not wish to include a written response.I will be turning in a written response.

I understand that checking this box constitutes a legal signature. I agree to be legally bound by this digital signature.

Employee’s signature on this document is acknowledgement that this matter and corrective action has been discussed with him/her and the employee reviewed it prior to its placement in their personnel file.I understand.

Today's Date

First and Last Name

Birthdate

Social Security Number

Employee Warning Notice

Remediation

Superviosor Acknowledgement of Digital Signature

Employee Acknowledgment and Response

Verification