Employee Written Warning Form

Document Overview

This is a fillable employee written warning form. Click any blank field in the document below, type your information, and your entries will autosave in your browser. Use the toolbar at the top to print, save as PDF, or download a completed copy. Below the form, you'll find a guide to using this document, common mistakes to avoid, and answers to the questions we hear most often about employee written warning form.

Date: Date	Employee's Name: Name	Department: Department
Title: Title	Date of Incident: Date

1. Has a verbal warning been given? Yes / No

• No

2. Type of warning  First Warning / Final Warning

• First written warning
• Final written warning

3. Explain why this warning is being given (Additional information can be provided below).

• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Tardiness / Failure to give timely notification of absence / Timecard/time clock violation Yes / No
• Other reason

4. Describe the employee's specific rule violation or performance problem:

• Reason For Warning 1 : Describe
• Reason For Warning 2 : Describe
• Reason For Warning 3 : Describe
• Reason For Warning 4 : Describe
• Reason For Warning 5 : Describe
• Reason For Warning 6 : Describe
• Reason For Warning 7 : Describe
• Reason For Warning 8 : Describe
• Reason For Warning 9 : Describe
• Reason For Warning 10 : Describe
• Reason For Warning 11 : Describe
• Reason For Warning 12 : Describe
• Reason For Warning 13 : Describe
• Reason For Warning 14 : Describe
• Reason For Warning 15 : Describe
• Other Reason For Warning : Describe

5. Describe the change in behavior that is expected of the employee:
Describe

6. Describe the consequences if this behavior is not changed:
Describe

7. Employee statement or rebuttal:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

TO BE READ AND SIGNED BY THE EMPLOYEE:

The above problem(s) have been discussed with me, and I understand that failure to improve my performance or additional unsatisfactory behavior will result in further disciplinary action, up to and including suspension or termination. I understand that my signature does not necessarily signify agreement with the facts or actions stated. If I disagree, it is my option and responsibility to pursue an appeal as follows: Describe

Employee's signature: ________________________________ Date: ____________________

-or-
Employee was asked to sign this written warning on   _______________   but declined to sign.

Witnessed by: ________________________________________ Date: ____________________
Name:
Title:

Supervisor's signature: _______________________________________ Date: _____________