HPU FORM | Discipline Notice – HPU | Hibbing Public Utilities

Employee

First

Last

Discipline

(DVW) Document Verbal Warning [ 18 Months in Personnel File ]
(W) Written Reprimand [ 18 Months in Personnel File ]
(TL1) Temporary Layoff - without pay for 1 day (8 hrs) [ 24 Months in Personnel File ]
(TL3) Temporary Layoff - without pay for 3 days (24 hrs) [ 30 Months in Personnel File ]
(TL5) Temporary Layoff - without pay for 5 day (40 hrs) [ 30 Months in Personnel File ]
Discharge

1. Statement of the incident:

2. Statement of company policy on this subject:

3. Consequences of failure to correct behavior:

4. Employee comments:

union Layout incident:

Was the employee asked if they wanted union representation at the meeting?

Did the employee want union representation?

Does the employee want a copy of this notice sent to the union?

Employee Name (Printed)

First

Last

Employee Signature

Clear Signature

Date

Supervisor Name (Printed)

First

Last

Supervisor Signature

Clear Signature

Date

Discipline Notice