[{"id":"fcd567ce-eae0-428d-b512-55913d34e67f","order":1,"text":"EMPLOYEE DISCIPLINARY ACTION FORM","fontSize":"20","textAlign":"center","bold":true,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"23b49b3a-0477-49a2-83ec-ba7a676fc6c6","order":2,"text":"Employee Write-Up & Corrective Action Record","fontSize":"16","textAlign":"center","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"2fda0509-ab10-407f-908e-489da3ffce9f","order":3,"text":"CONFIDENTIAL — PERSONNEL RECORD","fontSize":"11","textAlign":"center","bold":true,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"b3821b3e-9f0d-4968-91c3-227748e2864a","order":4,"text":"Company: [Company name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"506b31ce-a66f-443d-83e6-ab9fc499a57b","order":5,"text":"Address: [Company address]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"d2e545f7-32ba-4f4c-b53b-416bf9eb3f02","order":6,"text":"Case / Reference No.: [Case reference]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"07c192a8-4c24-4598-9243-7f7f1ffd95b7","order":7,"text":"Date of This Notice: [Date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"315f4e7c-387e-4d72-9ca4-a534fdab1ce9","order":8,"text":"EMPLOYEE INFORMATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"6e1ddebc-b364-489a-a561-af1b99b417bd","order":9,"text":"Employee Name: [Employee name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"a618292c-fe96-4ca5-b67d-85cf97cca3db","order":10,"text":"Employee ID: [Employee ID] Job Title: [Job title]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"03c37f54-f828-4a39-934c-1069f7d96e90","order":11,"text":"Department: [Department] Date of Hire: [Date of hire]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"3c7e178e-3122-4c10-be1a-89b278fd85b3","order":12,"text":"Direct Supervisor: [Supervisor]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"a7eb281d-72a5-49c6-86e9-c770dd5e9d6f","order":13,"text":"DETAILS OF THE INCIDENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"2fc984f3-bd23-4037-a6b5-c80642ff9a80","order":14,"text":"This disciplinary action concerns an incident involving [Employee name] that occurred on [Incident date] at approximately [Time], at the following location: [Location].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7dd66470-0707-48b6-989a-e06d9f22aa2e","order":15,"text":"The facts giving rise to this notice are as follows:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"2f9849c5-7f99-4b08-94ee-be2ef6523689","order":16,"text":"[Description of the incident]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"0284abd1-868d-48dd-995a-1d8aa4647abb","order":17,"text":"NATURE OF THE VIOLATION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"e9e40dc6-7621-4886-97db-0efa2a3c524c","order":18,"text":"The conduct described above constitutes a violation in the category of: [Category].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"7525be5a-46d6-44d1-8842-3a513b5b0807","order":19,"text":"Specifically, this matter relates to a failure to comply with the following Company policy, rule, or standard of performance: [Policy reference].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"9e4594d1-56de-46e4-ac6a-8861c14f7ed7","order":20,"text":"DISCIPLINARY ACTION","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"eb909934-e538-40f5-8bc1-1f66437dbd28","order":21,"text":"In response to the conduct described herein, and in accordance with the Company's progressive discipline practices, the Company is taking the following disciplinary action with respect to [Employee name]: [Disciplinary level].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"f02b4a9a-bb68-47b4-a115-55cfcec30dcb","order":22,"text":"The employee is suspended from work, without pay unless otherwise required by applicable law, from [Start date] through [End date]. The employee is expected to return to their regular duties on the next scheduled workday following the end of the suspension period.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"a disciplinary suspension","type":"add","operator":"="}]},{"id":"98d88227-a633-4d95-b530-c0833b4fe26a","order":23,"text":"As a result, [Employee name]'s employment with the Company is terminated effective as of the date of this notice. The employee is directed to return all Company property in their possession and will be provided with information regarding final pay and the continuation of any applicable benefits in accordance with law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"add","operator":"="}]},{"id":"45b7934c-2989-41be-a3af-a11b8ba107db","order":24,"text":"PRIOR DISCIPLINARY HISTORY","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"a2a436b0-7180-47a0-bd7a-658679933079","value":"Yes","type":"add","operator":"="}]},{"id":"a4c4276a-f87f-4864-b5f4-ebd562f4eb2d","order":25,"text":"This is not an isolated occurrence. The employee has previously received [Number] prior disciplinary action(s) for similar or related conduct, summarized as follows:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"a2a436b0-7180-47a0-bd7a-658679933079","value":"Yes","type":"add","operator":"="}]},{"id":"81faa6bc-1287-4239-b64e-a75ba9ecaed3","order":26,"text":"[Prior history summary]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"a2a436b0-7180-47a0-bd7a-658679933079","value":"Yes","type":"add","operator":"="}]},{"id":"59e2f1a4-379e-4b5c-b0a2-e15ab893953e","order":27,"text":"CORRECTIVE ACTION AND EXPECTATIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"3bd4ab55-b94d-491d-a74b-0ba8d49dcf31","order":28,"text":"To remain in good standing, the employee is required to make the following corrective changes and meet the following expectations going forward:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"4a906311-3727-498a-a8f7-b39f0ef0fd53","order":29,"text":"[Required corrective action]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"b1167570-0387-4bbe-ac39-0b17221d26e9","order":30,"text":"The employee is expected to achieve sustained improvement no later than [Deadline]. Progress will be reviewed as follows: [Follow-up].","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"76c9cdb5-1fc5-4178-a2a2-486fa6c8cba2","order":31,"text":"CONSEQUENCES OF CONTINUED OR REPEATED VIOLATIONS","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10","displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"e66d070e-1622-4367-9b5c-0fb7d0dc35b3","order":32,"text":"The employee is advised that failure to correct the conduct described above, or any further violation of Company policy, may result in additional disciplinary action up to and including termination of employment. [Employee name] is encouraged to seek clarification from their supervisor or Human Resources regarding any of the expectations set forth in this notice.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true,"displayConditions":[{"field":"792f87cd-f54a-4c5a-875e-af4693ce39b7","value":"termination of employment","type":"remove","operator":"="}]},{"id":"e55b1431-230c-40c2-98de-2e664ad884ee","order":33,"text":"EMPLOYEE STATEMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"d4ceeb9c-809e-4797-81d7-3a03d42a8221","order":34,"text":"The employee has been given the opportunity to respond to this notice. The employee's statement is recorded below:","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"6","cflou":false,"active":true},{"id":"196e13e1-9e42-40a9-9354-18b7b580e96e","order":35,"text":"[Employee comments]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true},{"id":"b75283de-0ad7-481f-9c2b-ce60e1ca2800","order":36,"text":"The employee declined to sign this document. The employee's refusal to sign does not constitute disagreement with its contents and does not affect its validity. A witness has confirmed that the document was reviewed with the employee.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"10","cflou":false,"active":true,"displayConditions":[{"field":"ed882ced-86ac-472b-996f-bf982f6c911e","value":"Yes","type":"add","operator":"="}]},{"id":"c3530334-c12e-46b8-a48b-2903028ae940","order":37,"text":"ACKNOWLEDGMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"10"},{"id":"e1347c3c-77e3-4d29-b755-8a28712ef61a","order":38,"text":"My signature below acknowledges that this disciplinary action has been discussed with me and that I have received a copy of this notice. My signature indicates receipt and understanding only; it does not necessarily indicate agreement with the contents.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"1a58496c-eabe-4c97-bf68-70601f3590b4","order":39,"text":"Employee Signature: ______________________________ Print Name: [Employee name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"4d5cf5fe-7d6c-4e20-ad9a-8dbac43801c3","order":40,"text":"Date: [Date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"9c2b331a-acb9-44ae-af88-d3e34428c38c","order":41,"text":"Supervisor Signature: ______________________________ Print Name: [Supervisor name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"b6e78d2e-6a5b-4fdc-b4a4-aae7d9410618","order":42,"text":"Title: [Title] Date: [Date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"92cc8046-09fe-4d7a-ab47-b8f82b7bd66d","order":43,"text":"Witness Signature: ______________________________ Print Name: [Witness name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"795f583a-d623-4c72-af73-955a00d1a061","order":44,"text":"Date: [Date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"06e73f55-8c15-43ed-81ed-5fbdc42664fe","order":45,"text":"HR Representative Signature: ______________________________ Print Name: [HR name]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"4","cflou":false,"active":true},{"id":"48657d6e-0d97-4c18-9ae3-a2c23c6789c1","order":46,"text":"Date: [Date]","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"23e027a3-11be-4f82-b45f-fb491dc3d4ec","order":47,"text":"AT-WILL EMPLOYMENT","fontSize":"16","textAlign":"left","bold":true,"underline":false,"marginBottom":"10","cflou":false,"active":true,"marginTop":"20"},{"id":"b273884b-5eb2-47cf-b0fe-fdc12205d960","order":48,"text":"Nothing in this document creates a contract of employment or alters the at-will nature of the employee's employment, where applicable. Unless a written agreement signed by an authorized representative of [Company name] states otherwise, employment remains at-will and may be terminated by either the employee or the Company at any time, with or without cause or notice, to the extent permitted by applicable law.","fontSize":"14","textAlign":"left","bold":false,"underline":false,"marginBottom":"20","cflou":false,"active":true},{"id":"94fa3ddf-bf4c-4d30-9fcb-c7340acfcb91","order":49,"text":"This document is a confidential personnel record. It is maintained by Human Resources and access is restricted to authorized personnel with a legitimate business need, consistent with applicable law.","fontSize":"11","textAlign":"left","bold":false,"underline":false,"marginBottom":"0","cflou":false,"active":true}]