[Your Name]

[Company Name]

[Street Address]

[City, ST ZIP Code]

[Date]

[Recipient Name]

[Street Address]

[City, ST ZIP Code]

Dear [Recipient Name]:

We regret to inform you that your employment with [Company Name] is being terminated, effective [date]. Your termination is the result of the following violations of company policy:

[Violation], [date]

[Violation], [date]

[Violation], [date]

You were issued written warnings on [date], [date], and [date]. Copies of these warnings, signed by you, are in your personnel file. Your signature on each warning indicates that you discussed it with your manager, including steps you could take to correct the behavior cited in the warnings. As stated in your final warning, you needed to take steps to correct your behavior by [date]. Your failure to do so has resulted in your termination.

To appeal this termination, you must return written notification of your intention to appeal to [Name] in Human Resources no later than [time] on [date].

Sincerely,

[Your Name]

[Title]

cc: [Manager’s Name]