Cartage Australia Pty Ltd
ABN 60 108 355 344
PO Box 879 Cranbourne Vic 3977
Tel: (03) 5996 1019

Disciplinary Summary Dismissal Form

STRICTLY PRIVATE AND CONFIDENTIAL

This form is to be used for a Summary Dismissal ONLY

Two (2) Management Representatives must be present in the termination meeting.
A Summary Dismissal cannot be executed without the Div/Gen Manager’s approval.
This form must be initiated by the Pay Office.

Contact the HR Manager for further guidance and assistance.

Employee Details

Employee

Lookup

If your Employee Code is not yet in the system please manually add your details below.

First Name *

Last Name *

Email Address *For posting of your record of transaction.

Job Title *

Termination Details

Termination Statement

This is to confirm that your employment with this Company is terminated effective as per the details below.

Termination Date and Time *

Termination Reason *

All outstanding entitlements, such as annual leave accruals, will be paid into your bank account.

Is this abandonment of employment? *

YesNo

In case of abandonment of employment, this notice shall be forwarded by certified mail addressed to the employee at his/her last known address.

Notice Meeting Details

Is a Support Person Present? *

YesNo

Support Person Name

Notice Meeting Date and Time *

Management Representative 1 *

Title *

Other Management Representative 1 *

Manager Email *

Manager Type

Management Representative 2 *

Title *

Other Management Representative 2 *

Second Manager Email *

Second Manager Type

Employee Signature

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Employee may choose not to sign – the interview remains on record.

Support Person Signature

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Employee may choose not to sign – the interview remains on record.

Management Representative 1 Signature *

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Management Representative 2 Signature *

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Verify *

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