Knowledgebase-Performance Correction Notice


Information Product

Title:Performance Correction Notice
Summary:MTAS was asked to provide a performance correction notice for the City of Dunlap.
Original Author:Nevad, Warren
Co-Author:
Product Create Date:01/13/2004
Last Reviewed on::03/22/2010
Subject:Personnel--Discipline; Personnel--Performance measurement; Personnel--Performance appraisal; Personnel--Forms
Type:Form
Original Document: Performance Correction Notice.pdf

Reference Documents:

Text of Document: Performance Correction Notice.DOC




CITY OF DUNLAP PERFORMANCE CORRECTION NOTICE

Employee Name: Department:
Date Presented: Supervisor:


Disciplinary Level
Verbal Correction - (To memorialize the conversation.)
_ Written Warning - (State nature of offense, method of correction,
and action to be taken if offense is repeated.)
Investigatory Leave - (Include length of time and nature of review.)
__ Final Written Warning
Without decision-making leave
_ With decision-making leave (Attach memo of instructions.)
With unpaid suspension

Subject: ______________________________________________________________________
_ Policy/Procedure Violation
_ Performance Transgression
_ Behavior/Conduct Infraction
Absenteeism and Tardiness

Prior Notifications
Level of Discipline Date Subject

Verbal ____ __________________________
Written
Final Written


Incident Description and Supporting Details: Include the following information: Time, Place, Date of Occurrence,
and Persons Present as well as Organizational Impact.




Performance Improvement Plan

1. Measurable/Tangible Improvement Goals:

2. Training or Special Direction to Be Provided:

3. Interim Performance Evaluation Necessary?

4. In addition, I recognize that you may have certain ideas to improve your performance. Therefore, I encourage
you to provide your own Personal Improvement Plan Input and Suggestions:



(Attach additional sheets if needed.)



Outcomes and Consequences

Positive:

Negative:

Scheduled Review Date:



Employee Comments and/or Rebuttal



(Attach additional sheets if needed.)

X
Employee Signature


Employee Acknowledgment

I understand that the City of Dunlap is an “at-will” employer, meaning that my employment has no specified
term and that the employment relationship may be terminated any time at the will of either party on notice
to the other. I also realize that the City of Dunlap is opting to provide me with corrective action measures,
and can terminate such corrective measures at any time, solely at its own discretion, and that the use of
progressive discipline will not change my at-will employment status.

I have received a copy of this notification. It has been discussed with me, and I have been advised to take
time to consider it before I sign it. I have freely chosen to agree to it, and I accept full responsibility for my
actions. By signing this, I commit to follow the city’s standards of performance and conduct.

_____________________ _________________
Employee Signature Date Supervisor’s Signature Date

Witness: (if employee refuses to sign)


Name Date Time in conference

Distribution of copies: Employee Supervisor Department Head Human Resources