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Free Disciplinary Acknowledgement Template

Create a professional disciplinary acknowledgement form that follows the UK ACAS Code of Practice. Fill in the details, preview, and download as a PDF in minutes. This template is designed for British employers operating under English employment law.

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DISCIPLINARY ACKNOWLEDGEMENT
United Kingdom  ·  ACAS Code Of Practice  ·  Employment Rights Act 1996
EMPLOYER
Redwood Services Limited
42 Business Park, Leeds LS1 1AA
HR Department, 0113 456 7890
hr@redwoodservices.co.uk
EMPLOYEE
Karen Elizabeth Bailey
17 Willow Gardens, Leeds LS11 2PQ
Customer Service Advisor · Customer Operations
Employee ID: RS-0472
Outcome: First Written Warning
Dated: 2026-03-09 · Hearing: 2026-03-08
This Disciplinary Acknowledgement (the "Acknowledgement") is issued on 2026-03-09 by Redwood Services Limited (the "Employer") to Karen Elizabeth Bailey, Customer Service Advisor (Customer Operations) (the "Employee"), whose continuous service commenced on 2023-06-12. It records the outcome of a disciplinary process conducted in accordance with the ACAS Code of Practice on Disciplinary and Grievance Procedures (2015), the Employer's internal Disciplinary Policy, and the Employment Rights Act 1996.
1.
RECEIPT OF DISCIPLINARY NOTICE
1.1 The Employee confirms receipt of this disciplinary notice dated 2026-03-09 and of the written statement of the matter, the evidence considered, and the outcome of the disciplinary hearing held on 2026-03-08, chaired by Tom Watkins (HR Manager). 1.2 The Employee acknowledges that a reasonable investigation was conducted prior to the hearing (Investigation reference: INV-2026-018), consistent with paragraphs 5-8 of the ACAS Code of Practice and the reasonable-belief test established in British Home Stores v Burchell [1978] IRLR 379.
2.
NATURE OF THE MATTER
2.1 The disciplinary action arises in respect of conduct, concerning matters arising on or around 2026-03-04:

During a team meeting held on 4 March 2026, the Employee directed inappropriate and offensive language at a colleague, Mr Ravi Patel, in breach of paragraph 4.2 of the Company Code of Conduct (respectful behaviour) and paragraph 2.1 of the Anti-Harassment Policy. The conduct was witnessed by two colleagues and was confirmed by the Employee in the investigation meeting on 6 March 2026.

2.2 Evidence considered at hearing:
Investigation report dated 6 March 2026
Witness statements of Mr J. Hughes and Ms S. Wright
Transcript of Employee's investigation interview
Employee's written response of 7 March 2026
3.
RIGHT TO BE ACCOMPANIED (ERA 1999, S.10)
3.1 The Employee was informed of the statutory right under section 10 of the Employment Relations Act 1999 to be accompanied at the disciplinary hearing by a fellow worker, a certified trade union representative, or an official employed by a trade union. 3.2 The Employee exercised that right and was accompanied by Laura Kinsella (Unison Workplace Representative).
4.
DECISION AND SANCTION
4.1 Following the disciplinary hearing and having given fair and equal weight to the evidence and to any representations advanced by the Employee, the Employer determines that a First Written Warning is a proportionate and reasonable response within the range of responses open to a reasonable employer (ERA 1996 s.98(4)). 4.2 This warning will remain live on the Employee's personnel record for 12 months from the date of this notice, after which it will be disregarded for further disciplinary purposes provided no similar matter arises.

4.3 Sanction details:
A First Written Warning is issued. It will remain live on the Employee's personnel record for 12 months from the date of this notice. A written apology to Mr Patel is required by 16 March 2026. Any repetition of similar conduct may result in further disciplinary action up to and including dismissal.
5.
EQUALITY AND REASONABLE ADJUSTMENTS
The Employer confirms that in conducting the disciplinary process it has considered and, where applicable, made reasonable adjustments required by section 20 of the Equality Act 2010, and that the decision has not been made by reference to any protected characteristic under Part 2 of that Act (age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, or sexual orientation).
6.
RIGHT OF APPEAL
6.1 In accordance with paragraphs 25-27 of the ACAS Code of Practice, the Employee has the right to appeal against this decision. Any appeal must be in writing, set out the specific grounds relied upon, and be submitted to Sarah Jones (Senior HR Business Partner) at Redwood Services Limited, 42 Business Park, Leeds LS1 1AA by no later than 2026-03-16. 6.2 The appeal will be heard without unreasonable delay by a manager not previously involved in the case, at a time and place which is reasonable and at which the Employee is again entitled to be accompanied under ERA 1999 s.10. 6.3 Failure by the Employer or Employee to comply with the ACAS Code may result in an uplift or reduction of up to 25% in any Employment Tribunal award under section 207A of the Trade Union and Labour Relations (Consolidation) Act 1992.
7.
IMPROVEMENT TARGETS AND SUPPORT
7.1 The following specific, measurable improvement targets have been agreed:

Maintain respectful, professional communication with all colleagues and customers at all times.
Complete mandatory Respect at Work training module by 30 April 2026.
Participate in fortnightly 1:1 check-ins with line manager for the first three months.

7.2 Support offered:
Access to Employee Assistance Programme (24/7 confidential line: 0800 123 4567).
Referral to Occupational Health if requested.
Reasonable adjustments under Equality Act 2010 s.20 if required.
8.
REVIEW AND MONITORING
8.1 A formal review of the Employee's progress against the agreed targets shall be held on 2026-06-09, conducted by Tom Watkins (HR Manager). 8.2 Failure to achieve and sustain the required standards during the monitoring period may result in further disciplinary action, up to and including dismissal, following a further fair process in accordance with the ACAS Code and the reasonableness test in Polkey v AE Dayton Services Ltd [1987] UKHL 8.

8.3 Additional notes:
The Employee has been reminded that this Acknowledgement is not an agreement with the decision, and signature is required solely as confirmation of receipt. The Employee's right of appeal is preserved in full.
9.
DATA PROTECTION AND CONFIDENTIALITY
The Employer shall process the Employee's personal data arising from this matter in accordance with the UK General Data Protection Regulation and the Data Protection Act 2018. The record of this matter will be retained for the duration of the live warning and for such further period as is necessary for legitimate HR, legal and audit purposes, and will be treated as confidential save for disclosure on a need-to-know basis or where required by law.
10.
EMPLOYMENT TRIBUNAL TIME LIMITS
Nothing in this Acknowledgement is intended to affect the Employee's statutory rights. The Employee is reminded that any Employment Tribunal claim must generally be presented within three months less one day of the act complained of (ERA 1996 s.111 / Equality Act 2010 s.123), subject to the extension afforded by ACAS Early Conciliation under section 18A of the Employment Tribunals Act 1996.
11.
GOVERNING LAW
This Acknowledgement shall be governed by and construed in accordance with the law of England and Wales (or Scotland / Northern Ireland where applicable), without prejudice to any overriding statutory employment protections. The rights of any third party under the Contracts (Rights of Third Parties) Act 1999 are excluded.
FOR THE EMPLOYER
Tom Watkins (HR Manager)
Date: ____________________
EMPLOYEE (RECEIPT)
Karen Elizabeth Bailey
Date: ____________________

What Is a Disciplinary Acknowledgement?

A disciplinary acknowledgement is a document that records an employee's receipt and understanding of a disciplinary action taken against them. It confirms that the employee has been informed of the nature of the concern, the outcome of the disciplinary process, and any consequences or conditions going forward.

The ACAS Code of Practice on disciplinary and grievance procedures recommends that employers keep clear written records at every stage of the disciplinary process. An acknowledgement form provides documentary evidence that the employee was properly notified and given the opportunity to respond.

Using a standardised UK acknowledgement form helps employers demonstrate procedural fairness, which is a critical factor if a decision is later challenged at a British employment tribunal.

What's Covered in This Template

Our disciplinary acknowledgement template includes all the sections needed for a thorough and fair record of the process.

Employee Details

Full name, job title, department, and employee reference number.

Date of Disciplinary Meeting

The date the disciplinary hearing or meeting took place.

Nature of Misconduct

A clear description of the issue or behaviour that led to the disciplinary action.

Outcome of the Process

The formal outcome — verbal warning, first written warning, final written warning, or dismissal.

Expected Improvements

Specific standards of behaviour or performance the employee is expected to meet going forward.

Review Period

The timeframe during which the warning will remain active on the employee's record.

Right of Appeal

Confirmation of the employee's right to appeal the decision and the deadline for doing so.

Support and Training

Any additional support, training, or supervision the employer will provide to help the employee improve.

Employee Acknowledgement

A section for the employee to confirm they have read and understood the disciplinary outcome.

Signatures

Space for the employee, their line manager, and an HR representative to sign and date the form.

How to Create a Disciplinary Acknowledgement

Follow these steps to complete a disciplinary acknowledgement form using our template.

  1. 1

    Enter Employee and Meeting Details

    Fill in the employee's name, job title, department, and the date of the disciplinary meeting. Include the names of anyone else present at the hearing.

  2. 2

    Describe the Misconduct or Concern

    Provide a clear and factual description of the behaviour or performance issue that led to the disciplinary action. Reference any previous warnings if applicable.

  3. 3

    Record the Outcome

    State the formal outcome of the disciplinary process — whether it is a verbal warning, written warning, final written warning, or dismissal. Include the review period for any warning issued.

  4. 4

    Set Out Expected Improvements

    Define the specific improvements required, any targets or deadlines, and the support the employer will provide to help the employee meet those expectations.

  5. 5

    Obtain Signatures and Download

    Have the employee sign to acknowledge receipt. Download the completed form as a PDF and retain a copy in the employee's personnel file.

Legal Considerations

Disciplinary procedures in the UK must follow established legal principles and the ACAS Code of Practice.

This template is for informational purposes only and does not constitute legal advice. Consult a qualified solicitor for advice specific to your situation.

Reviewed for England & Wales law

ACAS Code of Practice

The UK ACAS Code of Practice on disciplinary and grievance procedures is not legally binding, but British employment tribunals are required to take it into account when considering relevant cases. Failure to follow the Code can result in an uplift of up to 25% on any compensation awarded. Key requirements include conducting a reasonable investigation, holding a meeting, and allowing the right of appeal.

Right to Be Accompanied

Under section 10 of the UK Employment Relations Act 1999, workers have the right to be accompanied at a disciplinary hearing by a trade union representative or a work colleague. The employer must allow the companion to address the hearing and confer with the worker, though they are not required to answer questions on the worker's behalf under English law.

Unfair Dismissal Protection

Employees with two or more years' continuous service have the right not to be unfairly dismissed under the UK Employment Rights Act 1996. If a disciplinary process leads to dismissal, the British employer must demonstrate that the dismissal was for a fair reason and that a fair procedure was followed. The band of reasonable responses test applies.

Record Keeping and Data Protection

UK employers should retain disciplinary records in accordance with their data retention policy and the UK GDPR. Warnings typically remain on file for a set period (commonly 6 to 12 months for written warnings). The employee has a right to access their personal data, including disciplinary records, under British data protection law.

Frequently Asked Questions

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