COUNSELLING

 FORM                                                                            ATTACHMENT  7.9(A)  

 
Name  of  Employee  :   _______________________________   SAMPLE  
Position  :     ________________________________________    
 
Department  :       ________________________________________  
 
  Reason(s) for this counselling
 
  _________________________________________________________________________
 
  _________________________________________________________________________
 
  _________________________________________________________________________
  _________________________________________________________________________
 
 
 
 
  Employee's Explanation:
 
  _________________________________________________________________________
 
  _________________________________________________________________________
  _________________________________________________________________________
 
  _________________________________________________________________________
 
 
 
 
Advice given
 
_________________________________________________________________________
 
  _________________________________________________________________________
 
  _________________________________________________________________________
 
This  counselling  session  was  conducted  by:  
Name   Position   Signature/Date  

1)      

2)      
 
 
 
______________________________     Date:  _________________________  
Signature  of  Employee  
 
   (Company  Letterhead)    
 
 
ATTACHMENT:    7.9(B)  
 
Date:              
SAMPLE  
Name  of  Employee  
Designation  /  Department  
 
Dear  ____________________  
 
LETTER  OF  EXPLANATION  
 
It   has   been   reported   that   you   have   been   found   to   have   committed   the   following   acts   of  
misconduct:  
 
a) _____________________  
b) _____________________  
c) _____________________  
 
You  are  hereby  required  to  provide  a  written  explanation  into  the  allegations  stated  above  on  
or  before  DD/MM/YYYYY.  
 
Please  take  note  that  if  your  explanation  is  not  received,  the  Management  will  assume  that  you  
are  guilty  of  the  said  allegations  above  and  have  no  explanation  to  offer  in  your  defense.  
 
Yours  faithfully,  
 
 
____________________________  
(Name  of  Signatory  and  Designation)  
 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    

Date:  DD/MM/YYYY  
                 
Name:  
Designation:  
Department  
 
Dear  __________________  
 
RE:  SHOW  CAUSE  LETTER  ON  INSUBORDINATION  
 
 
ALLEGATIONS  OF  MISCONDUCT  
 
Your   Superior,   ____________,   has   reported   the   following   acts   of   Insubordination  
committed  by  you:  
 
1. That   on   DD/MM/YYYY,   when   your   Superior   informed   you   that   your   leave  
application  for  DD  –  DD/MM/YYYY  could  not  be  approved,  you  rudely  informed  
her   that   henceforth,   you   would   not   apply   for   annual   leave   but   only   take  
emergency  leave.    You  were  thereafter  absent  on  purported  emergency  leave  on  
DD  –  DD/MM/YYYY.  
 
2. That   on   DD/MM/YYYY,   during   a   discussion   with   you   on   your   refusal   to   process  
the  ______  claim  for  ______________,  you  angrily  informed  her  that  you  would  
not   process   the   said   claims   and   rudely   walked   out   of   the   room   while   your  
Superior  was  still  talking  to  you.  
 
Your   act   amounts   to   gross   insubordination   and   insolence,   which   are   serious   acts  
of  misconducts.  
 
3. That  on  DD/MM/YYYY,  when  she  wanted  to  discuss  your  performance  with  you,  
you   rudely   told   her   that   you   were   not   satisfied   with   your   subordinate,  
____________,   and   threatened   to   physically   harm   her.     Your   act   amounts   to  
serious  misconduct.  
 
 
 
 
 
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 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    
 
 
Your   conduct   is   totally   unbecoming   of   an   employee   of   the   company   and   you   are,  
therefore,   required   to   submit   a   written   explanation   to   the   undersigned   on   or   before  
DD/MM/YYYY   as   to   why   disciplinary   action,   including   dismissal,   should   not   be   taken  
against  you.      
 
Pending  your  explanation  and  a  decision  by  the  management,  you  would  be  suspended  
from  work  with  half  pay  for  a  period  of  2  weeks  commencing  today/until  further  notice.  
During   the   period   of   your   suspension,   you   are   not   allowed   to   enter   the   company  
premises  or  carry  out  any  transaction  on  behalf  of  the  company  without  approval  from  
the  management.      
 
Please  take  note  that  if  your  explanation  is  not  received  or  is  found  to  be  unsatisfactory,  
appropriate  disciplinary  action  will  be  taken  against  you.  
 
Yours  faithfully,  
 
 
 
 
 
 
____________________________  
(Name  of  Signatory  and  Designation)  
 
 
 
 
 

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 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    

Date:  DD/MM/YYYY  

Name:  
Designation:  
Department  
 
Dear  ________________  
 
RE:  SHOW  CAUSE  ON  FALSE  MEDICAL  CERTIFICATE  
 
 
MEDICAL  CERTIFICATES  
 
It  is  noted  that  you  have  obtained  sick  leave  from  a  clinic  named  Klinik  ABC,  <Address>  
and  have  submitted  the  following  certificates  in  support  of  the  sick  leave:  
 
  Date  of  MC     M.C.  No.  
 
1.      
2.    
3.    
4.    
 
Investigations   by   the   management   indicate   that   there   is   no   such   clinic   at   the   said  
address  and  that  there  is  no  such  address  as  well.    In  view  of  this,  there  are  doubts  over  
the  veracity  of  the  certificates  that  you  have  submitted.      
 
You   are   therefore   required   to   give   a   written   explanation   to   the   undersigned   on   or  
before  _____  ________  20XX  as  to  how  you  obtained  the  said  certificates  from  a  non-­‐
existent  clinic.      
 
Please  take  note  that  if  it  is  established  that  there  is  no  such  clinic,  your  action  would  
not   only   amount   to   fraud   but   would   also   constitute   a   criminal   offence   which   may  
compel  the  company  to  make  a  police  report.      
 
You   are   also   to   take   note   that   if   your   explanation   is   not   received   or   is   found  
unacceptable,  appropriate  action  would  be  taken  against  you.  
 
 
 
 
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 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    
 
 
Pending  your  explanation  and  a  decision  by  the  company,  you  would  be  suspended  from  
work  until  DD/MM/YYYY.    During  the  period  of  your  suspension,  you  are  not  allowed  to  
enter   the   company   premises   or   carry   out   any   transaction   on   behalf   of   the   company  
without  prior  approval.  
 
 
Yours  faithfully,  
 
 
 
 
 
 
____________________________  
(Name  of  Signatory  and  Designation)  
 

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 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    

Date:  DD/MM/YYYY  
 
Name:  
Designation:  
Department  
 
Dear  ______________  
 
 
RE:  SHOW  CAUSE  ON  ABSENCE  &  ABANDONMENT  OF  EMPLOYMENT  
 
 
ABSENCE  FROM  WORK  
 
We   refer   to   the   above   and   note   that   you   have   been   absent   from   work   since  
DD/MM/YYYY.  
 
We  note  that  you  have  on  a  few  occasions  sent  “SMS”  text  messages  stating  that  you  
are   on   medical   leave.     However,   you   have   failed   to   provide   any   sick   certificates   in  
support  of  your  purported  sick  leave.  
     
By  your  absence  from  work  you  have  breached  your  contract  of  employment  for  which  
you  can  be  dismissed.    In  view  of  this,  you  are  required  to  provide  a  written  explanation  
to  the  undersigned,  on  or  before  DD/MM/YYYY,  with  supporting  documents  as  to  why  
you  should  not  be  dismissed.  
 
Please  take  note  that  if  your  explanation  is  not  received,  the  management  will  consider  
that   you   have   abandoned   your   employment   without   notice   and   will   reserve   the   right   to  
make  a  claim  against  you  for  termination  benefits.    
 
 
Yours  faithfully,  
 
 
 
 
 
 
____________________________  
(Name  of  Signatory  and  Designation)  
 
 
 (Company  Letterhead)   SAMPLE  
 
Show  Cause  Letter  Samples  –  ATTACHMENT  7.9(C)    
 
Date:  DD/MM/YYYY  
 
Name:  
Designation:  
Department  
 
Dear  ______________  
 
RE:  SHOW  CAUSE  LETTER  ON  ASSAULT  OR  ASSAULTING  FELLOW  EMPLOYEE  
 
It   has   been   reported   that   on   DD/MM/YYYY   3.30pm,   near   the   <LOCATION>   in   the  
Factory,  you  deliberately  hit  another  employee,  named  <NAME  OF  THE  EMPLOYEE  WHO  
WAS  HIT>,  with  a  wooden  stick.  
 
Hitting  another  employee  in  the  company  premises  is  serious  misconduct  and  you  are,  
therefore,   required   to   give   a   written   explanation   to   the   undersigned   on   or   before  
DD/MM/YYYY  as  to  why  disciplinary  action  should  not  be  taken  against  you.  
 
Please   take   note   if   your   explanation   is   not   received   or   is   found   to   be   unsatisfactory,   the  
company  would  proceed  with  appropriate  disciplinary  action.  
 
Pending   your   explanation   and   a   decision   by   management,   you   would   be   suspended  
from  work  on  half  wages  up  to  DD/MM/YYYY.  
 
 
Yours  faithfully,  
 
 
 
 
____________________________  
(Name  of  Signatory  and  Designation)