Who is Employee?

• Indicate the full name of a person who is being suspended (Employee):

• Indicate the Employee's full job title:

• Indicate Employee's mailing address:

Incident's Details

• Select the date on which the incident leading to suspension occurred:

• Describe in detail the incident leading to suspension:

• Indicate the name of the internal policy document, as well as the clause number that was violated in the incident involving the employee:

Suspension Details

• Is the employee entitled to compensation during the suspension period?

  • No, it is unpaid suspension
  • Yes, it is fully paid suspension
  • Yes, it is partially paid suspension

• Describe in detail how Employee should be paid during the suspension period:

• Select the date on which the employee’s suspension from work should begin:

• Should the employee return all work-related equipment (e.g., laptop, mobile phone) for the duration of the suspension?

  • No
  • Yes

• Shall Employee be restricted from participating in any competing activities with Employer during the suspension period?

  • No
  • Yes

  !

  Competing activity includes working as an employee, contractor, consultant, owner, partner, or advisor for any competing entity with Employer.

• Do you want to add a signature?

  • Yes
  • No

• Employer's signature:

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