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  1	
  
(Company	
  Name)	
  
(Company	
  Contact	
  Details)	
  
	
  
(Date)	
  
	
  
(Name	
  of	
  Employee)	
  
(Position	
  of	
  Employee)	
  
(Contact	
  Details	
  of	
  Employee)	
  
	
  
	
  
Subject:	
   NOTICE	
  TO	
  EXPLAIN	
  
	
   	
   WITH	
  NOTICE	
  OF	
  PREVENTIVE	
  SUSPENSION	
  
	
   	
   -­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐	
  
	
  
	
  
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.	
  
	
  
	
   Furthermore,	
   you	
   have	
   been	
   placed	
   under	
   a	
   30-­‐DAY	
   PREVENTIVE	
  
SUSPENSION	
   starting	
   on	
   _____________________,	
   2013.	
   Unless	
   earlier	
   lifted,	
   your	
  
preventive	
   suspension	
   will	
   end	
   on	
   __________________,	
   2013.	
   Note	
   that	
   preventive	
  
suspension	
   is	
   NOT	
   A	
   PENALTY.	
   The	
   company	
   resorted	
   to	
   preventive	
   suspension	
  
because	
  of	
  imminent	
  and	
  serious	
  threat	
  to	
  the	
  (choose	
  one	
  or	
  both	
  “lives”	
  and/or	
  
“properties”)	
   of	
   (choose	
   one	
   or	
   both	
   “your	
   employer”	
   and/or	
   “your	
   co-­
employees”)	
  as	
  may	
  be	
  reasonably	
  inferred	
  from	
  the	
  nature	
  of	
  the	
  charge(s	
  )	
  against	
  
you.	
  	
  
	
  
	
   This	
  Notice	
  consists	
  of	
  ____	
  pages,	
  plus	
  attachments.	
  
	
  
	
   Kindly	
  give	
  this	
  matter	
  your	
  priority	
  attention.	
  
	
  
	
  
	
  
  2	
  
	
   	
   	
   	
   	
   	
   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:	
  
	
  
(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):	
  
  3	
  
	
  
(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.)	
  	
  
	
  
	
  
	
  
	
  
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.	
  	
  
	
  

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Notice to Explain WITH PREVENTIVE SUSPENSION (Sample Form)

  • 1.   1   (Company  Name)   (Company  Contact  Details)     (Date)     (Name  of  Employee)   (Position  of  Employee)   (Contact  Details  of  Employee)       Subject:   NOTICE  TO  EXPLAIN       WITH  NOTICE  OF  PREVENTIVE  SUSPENSION       -­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐-­‐       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.       Furthermore,   you   have   been   placed   under   a   30-­‐DAY   PREVENTIVE   SUSPENSION   starting   on   _____________________,   2013.   Unless   earlier   lifted,   your   preventive   suspension   will   end   on   __________________,   2013.   Note   that   preventive   suspension   is   NOT   A   PENALTY.   The   company   resorted   to   preventive   suspension   because  of  imminent  and  serious  threat  to  the  (choose  one  or  both  “lives”  and/or   “properties”)   of   (choose   one   or   both   “your   employer”   and/or   “your   co-­ employees”)  as  may  be  reasonably  inferred  from  the  nature  of  the  charge(s  )  against   you.         This  Notice  consists  of  ____  pages,  plus  attachments.       Kindly  give  this  matter  your  priority  attention.        
  • 2.   2               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:     (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):  
  • 3.   3     (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.)             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.