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Câu lạc bộ Giám đốc nhân sự - Trụ sở: CT4.1001, Đô thị Sông Đà - Mỹ Đình, Từ Liêm, Hà Nội - Điện thoại: 04. 7855518 - Fax: 04. 7855518 - Website: www.cpoclub.net - Email: contact@cpoclub.net Record of Disciplinary Action Employee Name Employee Title Manager Name Manager Title Today’s Date Incident Date Incident Time Incident Location Description of the incident that occurred: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________ Witnesses to the incident (if applicable): __________________________________________________________________________________ ________________________________________________________________________________ _________________________________________________________________________________ Names of those in attendance at current disciplinary action meeting: __________________________________________________________________________________ __ __________________________________________________________________________________ __ __________________________________________________________________________________ __ Corrective or disciplinary action to be taken:  Verbal  Written  Probation  Suspension  Other (explain below) __________________________________________________________________________________ __________________________________________________________________________________ ____ __________________________________________________________________________________ __________________________________________________________________________________ ____ (If on probation, period begins ___________________ and ends ___________________.) Goals to be Achieved: __________________________________________________________________________________ __ __________________________________________________________________________________ __ __________________________________________________________________________________ __ Consequences for failure to improve performance or correct behavior: Câu lạc bộ Giám đốc nhân sự - Trụ sở: CT4.1001, Đô thị Sông Đà - Mỹ Đình, Từ Liêm, Hà Nội - Điện thoại: 04. 7855518 - Fax: 04. 7855518 - Website: www.cpoclub.net - Email: contact@cpoclub.net __________________________________________________________________________________ _ __________________________________________________________________________________ _ __________________________________________________________________________________ _ Prior discussions or warnings on this subject, whether oral or written: __________________________________________________________________________________ __________________________________________________________________________________ ____ Employee statement: __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ ____________ I acknowledge that I have read and understand the above information and consequences. _______________________________ ______________________ Employee Signature Ngày _______________________________ ______________________ Supervisor Signature Ngày . __________________________________________________________________________________ __ Consequences for failure to improve performance or correct behavior: Câu lạc bộ Giám đốc nhân sự - Trụ sở: CT4.1001, Đô thị Sông Đà - Mỹ Đình,. Signature Ngày _______________________________ ______________________ Supervisor Signature Ngày

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