Notice to Explain SAMPLE FORM (First Notice)

1. 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.   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.   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.