Form 153067 Written Warning Form - Paychex

ADVERTISEMENT
WRITTEN WARNING
Confidential
Employee Name _____________________________________________
Department __________________
Date(s) of Deficiency
Hire Date
/
/
Details of Incident
(Specifically what, where, when, and how employee’s performance and behavior was unacceptable)
__________________________________________________________________________________________
__________________________________________________________________________________________
Describe Extenuating Circumstance, if any ________________________________________________________
__________________________________________________________________________________________
Plan for Improvement ________________________________________________________________________
__________________________________________________________________________________________
Previous Twelve-Month History of Deficiencies
Date
Deficiency
Disciplinary Action Taken
____ /____ /______
_______________________________________
________________________________
____ /____ /______
_______________________________________
________________________________
____ /____ /______
_______________________________________
________________________________
Further Action
(for example, final written warning)
__________________________________________________________________________________________
__________________________________________________________________________________________
Supervisor Signature _______________________________________________ Date
/
/
nd
2
Level Management _____________________________________________ Date
/
/
rd
3
Level Management/HR Department _________________________________ Date
/
/
Employee Comments ________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
I have read and understand the nature of this deficiency and understand that if this persists, further disciplinary
action, up to and including termination of my employment, may occur. I also understand that the imposition of
disciplinary action, up to and including termination, is not preconditioned upon receipt of verbal or written notice of
unacceptable conduct.
Employee Signature________________________________________________ Date
/
/
©2007 Paychex, Inc
153067 1/07
WRITTEN WARNING
Confidential
Employee Name _____________________________________________
Department __________________
Date(s) of Deficiency
Hire Date
/
/
Details of Incident
(Specifically what, where, when, and how employee’s performance and behavior was unacceptable)
__________________________________________________________________________________________
__________________________________________________________________________________________
Describe Extenuating Circumstance, if any ________________________________________________________
__________________________________________________________________________________________
Plan for Improvement ________________________________________________________________________
__________________________________________________________________________________________
Previous Twelve-Month History of Deficiencies
Date
Deficiency
Disciplinary Action Taken
____ /____ /______
_______________________________________
________________________________
____ /____ /______
_______________________________________
________________________________
____ /____ /______
_______________________________________
________________________________
Further Action
(for example, final written warning)
__________________________________________________________________________________________
__________________________________________________________________________________________
Supervisor Signature _______________________________________________ Date
/
/
nd
2
Level Management _____________________________________________ Date
/
/
rd
3
Level Management/HR Department _________________________________ Date
/
/
Employee Comments ________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
I have read and understand the nature of this deficiency and understand that if this persists, further disciplinary
action, up to and including termination of my employment, may occur. I also understand that the imposition of
disciplinary action, up to and including termination, is not preconditioned upon receipt of verbal or written notice of
unacceptable conduct.
Employee Signature________________________________________________ Date
/
/
©2007 Paychex, Inc
153067 1/07

Download Form 153067 Written Warning Form - Paychex

391 times
Rate
4.3(4.3 / 5) 26 votes
ADVERTISEMENT