This document is a notice to an employee requesting a written explanation for disciplinary charges within five days, and a conference will be held for further discussion. It outlines the potential penalties for the employee if found guilty, including termination. The notice includes specific instructions for acknowledging receipt and details about the nature of the offenses and necessary documentation.

1. 1
(Company
Name)
(Company
Contact
Details)
(Date)
(Name
of
Employee)
(Position
of
Employee)
(Contact
Details
of
Employee)
Subject:
NOTICE
TO
EXPLAIN
-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐
Dear
Mr./Ms.
(Surname
of
Employee):
Please
submit
your
written
explanation
to
the
DISCIPLINARY
MATTER(S)
being
charged
against
you
described
or
narrated
below
within
FIVE
(5)
DAYS
from
the
date
that
this
Notice
was
served
upon
you.
Also,
please
attend
the
conference
to
be
held
on
_________________,
2013
at
______
(am/pm)
at
______________________________
as
this
will
give
you
additional
opportunity
to
verbally
explain
your
side
and
present
your
witnesses
and
other
evidence
regarding
the
said
disciplinary
matter(s).
You
have
the
right
to
be
represented
by
any
counsel
or
person
of
your
choice.
In
the
event
that
you
are
found
guilty
of
the
said
charge(s),
the
company
may
terminate
you
from
employment
and/or
impose
other
appropriate
penalties.
This
Notice
consists
of
____
pages,
plus
attachments.
Kindly
give
this
matter
your
priority
attention.
Very
truly
yours,
(Name
of
Disciplinary
Officer)
(Position
of
Disciplinary
Officer)
(Contact
Details
of
Disciplinary
Officer)
DISCIPLINARY
MATTER(S):
What
was/were
the
offense(s)
committed:

2. 2
(Identify
the
name(s)
of
the
offense(s)
and
the
article(s)
&
section(s)
where
it/they
is/are
found
in
the
Labor
Code
and/or
in
the
company
personnel
policies.)
When
was/were
the
offense(s)
committed
(date
&
time):
(If
the
exact
date
and
time
is
not
certain
or
available,
indicate
the
time
period
covered
instead.)
Where
was/were
the
offense(s)
committed:
(If
the
exact
location
is
not
certain
or
available,
indicate
the
vicinity
where
the
offense
was
committed.)
Who
is/are
being
charged
of
the
offense(s):
(Indicate
all
the
employees
being
charged
with
the
same
offense.)
Who
is/are
the
witness(es):
(Name
all
the
witnesses.
Attach
their
written
reports
or
statements
to
this
Notice.
Expressly
mention
in
this
Notice
what
are
the
documents
that
are
attached.)
How
was/were
the
offense(s)
committed:
(Give
a
brief
description,
story
or
narrative
on
how
the
offense
was
committed
and
why
the
subject
employee
is
being
charged
in
connection
with
the
said
offense.
Attached
the
incident
reports,
police
reports,
security
guard’s
reports,
audit
reports,
photos,
and
other
documents
that
can
help
describe
the
offense.
Expressly
mention
in
this
Notice
what
are
the
documents
that
are
attached.)
How
much
was
involved
(if
any):
(If
property,
estimate
the
value
of
the
property
lost
or
damaged.
If
it
cannot
be
estimated
(e.g.
lost
documents),
say
that
“the
value
is
beyond
pecuniary
estimation.”)
How
did
the
offense
adversely
affect
the
company:
(Give
brief
description.
This
should
directly
or
indirectly
justify
why
the
employee
should
be
terminated,
if
found
guilty.)

3. 3
ACKNOWLEDGMENT
RECEIPT
OF
NOTICE:
Signature
Over
Printed
Name:
_______________________________________________________
Date:
____________________________
Time:
___________________________
WITNESS
TO
THE
SERVICE
OF
NOTICE:
Signature
Over
Printed
Name:
_______________________________________________________
Date:
____________________________
Time:
___________________________
Instruction
to
the
Notice
Server:
1. Give
1
copy
of
the
Notice
to
the
subject
employee.
2. Request
him/her
to
completely
fill-­‐up
and
sign
the
ACKNOWLEDGMENT
RECEIPT
OF
NOTICE
on
company’s
copy
of
the
Notice.
3. Fill-­‐up
and
sign
the
WITNESS
TO
THE
SERVICE
OF
NOTICE
on
company’s
copy,
placing
YOUR
OWN
NAME
and
SIGNATURE.
4. However,
if
the
employee
refuses
to
sign,
don’t
insist
or
argue.
Just
leave
a
copy
of
the
Notice
on
his/her
cubicle,
table
or
desk.
a. Then
fill-­‐up
and
sign
the
ACKNOWLEDGMENT
RECEIPT
OF
NOTICE
of
company’s
copy,
placing
YOUR
OWN
NAME
and
SIGNATURE
with
a
note:
“EMPLOYEE
REFUSED
TO
RECEIVED”.
b. And
if
there
are
OTHER
witnesses,
request
one
of
them
to
sign
as
witness
on
the
WITNESS
TO
THE
SERVICE
OF
NOTICE.
5. Return
the
company’s
copy
to
the
HR
Manager
for
safekeeping.
6. If
the
Notice
cannot
be
delivered
PERSONALLY
to
the
subject
employee,
then
you
must
send
it
to
him/her
by
way
of
registered
mail
(with
return
card)
using
his/her
last
known
address.