DUSTERS TOTAL SOLUTIONS PVT LTD
INCIDENT REPORT
Sl. Contents Particulars
Details of delinquent employee
1
Name: 1) BIRJU OMPAL DHARIWAL (0253183)
2) SOMNATH DINKAR JADHAV (0253181)
3) RITESH CHANDRAKANT CHAUHAN (0253184)
PepsiCo, India
2 Site Name & Address:
Nature of misconduct
(e.g. Habitual absenteeism / Coming late, Disobedience, Negligence of duty, Overstaying Negligence of duty
3 Leave, Obtaining leave on false grounds, Theft, Sleeping/ Drunkenness while on duty,
Chewing Tobacco, Misuse/Causing loss to the property, Passing indecent remarks,
Assault/Fighting, Defamation, Entering in/Smoking at prohibited place, Loitering, Receiving
Commission/Gifts/Bribe, Fraud, Breach of Company Policy/Rules & regulations etc.)
4 Date: Time: . Shift: __ (I / II / III / General) Place of Incident: ___ _________
Client –
5 Did incident occur in presence of other employees (if yes, Name,
Employee code & Designation) or Client (Name & Designation)
6 Detailed description about the misconduct—
As above mentioned employee not proper work as per client & not maintain rule & regulation
No
7 Past History of misconduct, if any
No
8 Have we taken any disciplinary action in past on above said employee?
Mr KC Nanada
9 Full Name of Superior / Reporting Manager
10 Name and designation of employee who has recorded this Incident Report
Name: KC Nanada Designation: OM Signature:
Note: Incomplete Incident Report will not be entertained and no action will be taken by HR Dept. against delinquent employee.
FM/HR/17
REVISION No:00