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The document is a Disciplinary Inquiry Form used by Employee Relations to record disciplinary actions against an employee, including various types of warnings and potential dismissal. It outlines the details of the misconduct, mitigating and aggravating circumstances, and includes sections for signatures from the employee, representative, and human resources. The form emphasizes the importance of accountability and remorse from the employee regarding their actions.

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yunusbhorat
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13 views3 pages

Paper 1

The document is a Disciplinary Inquiry Form used by Employee Relations to record disciplinary actions against an employee, including various types of warnings and potential dismissal. It outlines the details of the misconduct, mitigating and aggravating circumstances, and includes sections for signatures from the employee, representative, and human resources. The form emphasizes the importance of accountability and remorse from the employee regarding their actions.

Uploaded by

yunusbhorat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Annexure 9 - Disciplinary Inquiry Form

For use by Employee Relations only

DATA BASE DATA BASE


INFORMATION REFERENCE
Verbal Warning

APPLICABLE FOR 4 EXPIRY DATE


Written Warning
MONTHS

APPLICABLE FOR 6 CLASSIFICATION


Serious Warning
MONTHS

Final Written Warning INITIAL O DA LR


APPLICABLE FOR 8
X MONTHS
Charge 8.3 c
X Charge 8.3 d
Final Written Warning with two
APPLICABLE FOR 12
weeks Suspension without
MONTHS after acceptance
remuneration (as alternative to
by employee in writing
Dismissal)

Suspension from _/ 20 ; to /_ /20_ _(totalling 2 weeks without remuneration)

DISMISSAL ALTERNATIVE SANCTION PROPOSED BY OFFENDER

EMPLOYEE'S NAME CN

DESIGNATION DIVISION

DATE OF MISCONDUCT
DESCRIPTION OF MISCONDUCT: (WHO, WHAT, WHERE, WHEN, HOW, WHY)
GENERAL: TOTAL DISCIPLINARY RECORD

DATE OF EMPLOYMENT

MITIGATING CIRCUMSTANCES AS PRESENTED:

AGGRAVATING CIRCUMSTANCES AS PRESENTED:

ADDITIONAL REMARKS BY CHAIRPERSON (add pages to Annexure 9 for detailed reasons):

It is admirable that the transgressor immediately took accountability of his actions, and displayed deep remorse for this
incident that occurred.

SIGNATURES

ISSUED BY
(CHAIRMAN)

NAME/ CO NUMBER DESIGNATION SIGNATURE


(IN BLOCK LETTERS

I HEREBY ACKNOWLEDGE THE WARNING TO REFRAIN FROM REPEATING ABOVEMENTIONED MISCONDUCT


I HEREBY ACKNOWLEDGE THE REASON/S FOR MY DISMISSAL
IN CASE OF SUSPENSION, I HEREBY AGREE TO THE SUSPENSION BEING WITHOUT REMUNERATION

EMPLOYEE

SIGNATURE CN DATE

REPRESENTATIVE

SIGNATURE CN DATE

HUMAN RESOURCES

SIGNATURE DESIGNATION DATE

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