Employee Disciplinary Report

Type of Action

Written Record of Verbal Reprimand

Written Reprimand

Disciplinary Suspension

Demotion

Termination

Date of Action

Name

Date of Hire

Rank

Station Shift

DISCIPLINARY ACTION IS BEING TAKEN FOR THE FOLLOWING REASONS INCLUDE DATES

EMPLOYMENT HISTORY include dates and explanations of any if relevant discipline and

THE FOLLOWING CORRECTIVE ACTION IS EXPECTED

Notice of Appeals Process

Disciplinary action at the level of a written reprimand, an unpaid suspension, demotion, or dismissal may be subject to appeal. The employee shall follow the procedure outlined in the Sun City Fire & Medical Department Operations Manual Procedure No. 13.12 in presenting the appeal to upper levels of management.

Employee Representative (optional)

Date

Employee's Signature

Date

Supervisor's Signature

Supervisor's Email

Notice of Appeals Process

TEL: (623) 974-2321