AALAT

L.L.C

Employee Name: Employee Title:

Manager Name: Manager Title:
Today´s Date: Incident Date:
Incident Time: Incident Location:

Witnesses: (if applicable)

____________________________________________________________________________________

____________________________________________________________________________________

Policies Violated: (please mention the article no)

______________________________________________________________________________

______________________________________________________________________________

Description of the incident that occurred:

______________________________________________________________________________

Verbal Written Suspension Other (if so,

please explain below)

Employee explanation: (if provided)

______________________________________________________________________________

______________________________________________________________________________

I acknowledge that I have read and understand the above information and
consequence

___________________________________________________________________

Employee Signature

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 AALAT
L.L.C

Date___________________________________________________________________

Supervisor Signature HRD

Signature

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