EMPLOYEE’S SIGNATURE. DATE: M0019B2 Copy — White (FSA Provider) Yellow (Employee) Pink (Employer) Gold (Associate) 12/13 IMPORTANT INFORMATION REGARDING PARTICIPATION IN THE FLEXIBLE BENEFITS PLAN I understand and agree to the following:
EMPLOYEE’S SIGNATURE. 3.2 The foregoing deductions shall be made from the second pay of each month and the amounts deducted by the Board, together with a list of the employees for whom deductions have been made, as soon as possible, but in no event later than ten (10) days thereafter.
EMPLOYEE’S SIGNATURE. The employee shall sign each evaluation form after review of its contents. Such signing does not indicate concurrence with the evaluation, but only indicates the employee has received and read the evaluation.
EMPLOYEE’S SIGNATURE. Whenever an employee is ordered to place his signature upon any document or report for disciplinary action, it is understood that said employee is merely acknowledging receipt of said document and does not indicate whether or not the employee agrees or disagrees with the document, report or disciplinary action.
EMPLOYEE’S SIGNATURE. (If the employee declines to sign, note accordingly) WITNESS NAME: WITNESS SIGNATURE: WITNESS NAME: WITNESS SIGNATURE: Copies: Employee Union Delegate (where applicable) Supervisor Personnel Records PRO FORMA DOCUMENT (F) RECORD OF TERMINATION OF EMPLOYMENT DATE: NAME: SITE: REASON FOR TERMINATION OF EMPLOYMENT: EMPLOYEE COMMENT SUPERVISOR’S NAME: SUPERVISOR’S SIGNATURE: EMPLOYEE’S SIGNATURE: (If the employee declines to sign, note accordingly) WITNESS NAME: WITNESS SIGNATURE: WITNESS NAME: WITNESS SIGNATURE: Copies: Employee Union Delegate (where applicable) Supervisor Personnel Records PRO FORMA DOCUMENT (G) (DATE) (NAME) (SITE ADDRESS) Dear (NAME), CONFIRMATION OF TERMINATION OF EMPLOYMENT I refer to our meeting of (date). A record of that meeting is attached. I confirm that your employment with (employing company) has been terminated pursuant to the Group’s Disciplinary Policy and Procedures. The termination takes effect from (insert date). You will receive (xxx) week’s pay in lieu of notice. If you do not understand this letter of the Disciplinary Policy and Procedures, please contact me immediately. Yours faithfully (employing company) (Supervisor’s name) (SUPERVISOR’S TITLE) Copies: Employee Union Delegate (where applicable) Supervisor Personnel records APPENDIX D BARTTER ENTERPRISES PTY LIMITED
EMPLOYEE’S SIGNATURE. Date As the parent or legal guardian of the student (under 18) signing above, I grant permission for my child to access networked computer services such as electronic mail and the Internet. I understand that this access is designed for educational purposes; however, I also recognize that some materials on the Internet may be objectionable, and I accept responsibility for guidance of Internet use by setting and conveying standards for my child to follow when selecting, sharing, researching, or exploring electronic information and media. Consent for Use By signing this form, you hereby accept and agree that your child’s rights to use the electronic resources provided by the District and/or the Kentucky Department of Education (KDE) are subject to the terms and conditions set forth in District policy/procedure. Please also be advised that data stored in relation to such services is managed by the District pursuant to policy 08.2323 and accompanying procedures. You also understand that the e-mail address provided to your child can also be used to access other electronic services or technologies that may or may not be sponsored by the District, which provide features such as online storage, online communications and collaborations, and instant messaging. Use of those services is subject to either standard consumer terms of use or a standard consent model. Data stored in those systems, where applicable, may be managed pursuant to the agreement between KDE and designated service providers or between the end user and the service provider. Before your child can use online services, he/she must accept the service agreement and, in certain cases, obtain your consent. Name of Parent/Guardian (Please print) Signature of Parent/Guardian Date Daytime Phone Number: Evening Phone Number: Prior to the student’s being granted independent access privileges, the following section must be completed for students under 18 years of age: NOTE: FEDERAL LAW REQUIRES THE DISTRICT TO MONITOR ONLINE ACTIVITIES OF MINORS.
EMPLOYEE’S SIGNATURE. (Employee ID No.) (Date)
EMPLOYEE’S SIGNATURE. (If the employee declines to sign, note accordingly) WITNESS NAME: WITNESS SIGNATURE: WITNESS NAME: WITNESS SIGNATURE: Copies: Employee Union Delegate (where applicable) Supervisor Personnel Records PRO FORMA DOCUMENT (C) RECORD OF FINAL WRITTEN WARNING DATE: NAME: SITE: REASON FOR WARNING: PERFORMANCE/BEHAVIOURAL STANDARD REQUIRED: EMPLOYEE COMMENT: DATE FOR REVIEW: This Final Written Warning has been issued under the group Disciplinary Policy and Procedures. Under this policy, failure to comply with reasonable requirements as to work performance and/or behaviour may result in termination of employment. A copy of the policy has been provided to the employee. SUPERVISOR’S NAME:
EMPLOYEE’S SIGNATURE. (If the employee declines to sign, note accordingly) WITNESS NAME: WITNESS SIGNATURE: WITNESS NAME: WITNESS SIGNATURE: Copies: Employee Union Delegate (where applicable) Supervisor Personnel Records PRO FORMA DOCUMENT (D) (DATE) (NAME) (SITE ADDRESS) Dear (NAME), CONFIRMATION OF FINAL WRITTEN WARNING I refer to our meeting of (date). A record of that meeting is attached. I confirm that you have been issued with a Final Written Warning, pursuant to the Group Disciplinary Policy and Procedures. In the event that you fail to meet the standards required by the Group, your employment with will be terminated. If you do not understand this letter or the Disciplinary Policy and Procedures, please contact me immediately. Yours faithfully (employing company)
EMPLOYEE’S SIGNATURE. I, the undersigned, authorized and irrevocably direct Innophos, Inc. to deduct from my wages each and every month dues and initiation fees which may be charged against me by Local 743 which is required to maintain me as a member in good standing in said Union, in accordance with the By-Laws of the Union and in compliance with the Labor-Management Relations Act of 1947. The amount deducted each month shall be forwarded to Local 743. The authorization and direction shall be irrevocable for the period of one (1) year, or until the termination of the collective agreement between the Company and Local 743, whichever occurs sooner; and I agree and direct that this authorization and direction shall be automatically renewed, and shall be irrevocable for successive periods of one (1) year each or for the period of each succeeding applicable collective agreement between the Company and Local 743, whichever shall be shorter, unless written notice is given by me to the Company not more than twenty (20) days and not less than ten (10) days prior to the expiration of each period of one (1) year, or of each applicable collective agreement between the Company and Local 743, whichever occurs sooner. EMPLOYEE’S SIGNATURE: Male Female Address: Zip Code: City: Starting Date: Home Phone: Date of Birth: Dept.: Clock No. Beneficiary: Relationship: Soc. Sec. No.: Date: • Amend paragraph 132, page 30 to read: The bargaining unit employees of the Waterway plant will be eligible to participate in the same Defined Contribution retirement plan that is provided to the salaried employees. • Delete the last sentence of paragraph 33, page 8, regarding payment for missed overtime hours. Paragraph to read: If an employee has been overlooked for an overtime assignment, the individual will be given the opportunity to work the equivalent hours when it is mutually convenient for the Company and the employee. The overtime opportunity must be completed within 30 days or the hours will be forfeited. If the overtime missed is four (4) or more hours, it is to be made up in not less than four (4) hour blocks. • Amend paragraph 64, page 15 to read:
