Employee warning notice
Employee’s name Date of warning
Type of violation
■ Attendance ■ Willful damage to material or equipment
■ Tardiness/leaving early ■ Violation of company policies or procedures
■ Rudeness to employees or clients ■ Insubordination
■ Unsatisfactory work quality ■ Violation of safety rules
■ Carelessness ■ Working on personal business
■ Failure to follow instructions ■ Other
Previous warnings
Oral Written Date Supervisor
1st warning
2nd warning
3rd warning
Employer statement Employee statement
Date of incident ■ I agree with the employer’s statement.
Time ■ I disagree with the employer’s description
Description of incident of the violation.
My reasons are
Action to be taken
■ Probation ■ Dismissal
■ Suspension ■ Other
Consequence should this incident occur again
I have read this employee-warning notice and understand it.
Signature of employee Date
Signature of supervisor who issued warning Date