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MIAMI-DADE COUNTY
DISCIPLINARY ACTION REPORT
DISTRIBUTION: One (1) Copy to Employee One (1) Copy to Personnel Division One (1) Copy to Division File
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Employee Name: Date of DAR:
Classification: Date of Hire: ID#
Employee Status:
Department Division Area Permanent Probational Other
You are hereby charged with violating the County’s Personnel Rules, Chapter VIII, Section 7: Paragraph:
(Attach additional sheets as necessary)
FACTS: (Description of specific actions, statements made by employee; attach statements of witness, if any, and attach copies of other
documents if appropriate. Also state reasons for recommendation).
(Attach additional sheets as necessary)
_____________________________________________________
Supervisor’s Signature Date
In signing this Report I acknowledge only that it has been discussed with me and that I have received a copy. I understand that I may
respond orally or in writing and that such response will be made a part of this Report and taken into consideration prior to a final
determination being made.
_____________________________________________________
Employee’s Signature Date
RECOMMENDED ACTION:
__________________________________________________________________________________________________________________
FINAL ACTION: __________________________ FINAL APPROVAL: __________________________ ____________________________
Signature Title
__________________
Date
Written Reprimand
Dismissal
Day(s) Suspension
Effective Date(s) __________________
Demotion