Disciplinary Action Form

Today's Date:*
MM slash DD slash YYYY
Date of Incident:*
MM slash DD slash YYYY

If multiple, please select range on next section.
Person Issuing:*
First Last
Person Receiving:*
First Last
Location of Person Receiving:*
What is their job title?*
Type of Disciplinary:*
Forms for all of these are in DropBox. Documentation completely filled out is not optional on the submission.
Are you taking their tips?*
I understand it is my responsibility to ensure this employee accurately claims $0 every shift worked on these shifts. If this is not done and payroll is processed, the employee will get paid $11 an hour plus tips, and this can not be fixed.
If it is a Speeding Ticket, please list the amount removed
Summary of issue*
Upload all documentation*
Drop files here or

Max. file size: 200 MB.
Not optional. Documentation is always required when submitting this form. Do not submit blank photo or you will be asked to resubmit. Thank you in advance!