WRITTEN WARNING / DISCIPLINARY NOTICE

Confidential — retain in personnel file

• **Employee:** [EMPLOYEE NAME] | **Job title:** [JOB TITLE] | **Department:** [DEPARTMENT]
• **Manager:** [MANAGER NAME]
• **Date of warning:** [DATE]
• **Warning level:** [ ] First written warning  [ ] Second written warning  [ ] Final written warning

Incident description

• **Date(s) of incident:** [DATES]
• **Location:** [LOCATION]
• **What happened:** [FACTUAL DESCRIPTION — who, what, when, where. Attach statements if applicable.]
• **Witnesses (if any):** [NAMES]

Policy or expectation violated

[REFERENCE THE SPECIFIC POLICY, HANDBOOK SECTION, OR PRIOR EXPECTATION — e.g. Handbook §4.2 Attendance; PIP dated (date).]

Prior related actions

[ ] None  [ ] Verbal counseling on [DATE]  [ ] Prior written warning(s) on [DATES]

Corrective expectations

[STATE EXACTLY WHAT MUST CHANGE, BY WHEN, AND HOW COMPLIANCE WILL BE MEASURED.]

Consequences

Further violations may result in additional disciplinary action, up to and including termination of employment.

Employee comments (optional)

___________________________________________________________________________

Acknowledgment

My signature confirms receipt and discussion of this notice. It does not necessarily indicate agreement. Refusal to sign will be noted with a witness present.

Employee signature: ___________________________  Date: ______________

Manager signature: ___________________________  Date: ______________

Witness (if needed): ___________________________  Date: ______________

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General template only — not legal advice. Have employment counsel review before use, especially for state-specific requirements. Downloaded from AskHrAI (https://askhrai.com/forms/written-warning-notice).