Name of employee: ___________________________________________
Section/ Place of work: _______________________________________
Service Number and/or ID. Number: _______________________________
Post title: __________________________________________________
Date and time of offence:______________________________________
Offence/Complaint: ___________________________________________
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Disciplinary Measure
In view of the offence described above, this serves as a verbal warning and will be valid for 3 months.
Should you be found guilty of a further similar offence whilst this warning is in force (date), the disciplinary action then imposed will be affected by this warning.
__________________________ ______________
Signature and name in print : Post title
_____________
Date
The signing of this warning by the employee means that he/she acknowledges that he/she received a warning and that he/she understands the contents thereof.
In the event of the employee’s refusal to sign, any person who was present when the warning was issued must sign.
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Signature of employee Date
