Unemployment Info for Zamp – MCON Management

Employee's Name *

First

Last

Last physical day of work? *

Separation date? *

Position / Job Title *

Who discharged the claimant – name and job title? *

What was the reason given to the claimant for the discharge? *

What was the date of the final incident? *

What was the final incident that resulted in the separation? *

How did the employer become aware of this incident? *

What is your understanding of what happened? *

Was it confirmed/investigated – how? *

Did the claimant admit, deny or provide an explanation for the violation? *

If terminated for job performance, were they ever able to perform the job to the employer’s expectations? *

Was the inadequate performance due to carelessness or negligence? *

Were they on a performance improvement plan? *

What rule, policy or policies did they violate? *

How would the claimant have known about the policy? *

• Why did this last incident warrant immediate discharge versus a lesser form of disciplinary action? *

What is the harm caused by the claimant’s conduct? (What effect does it have on the company, fellow employees, etc.?) *

Had the claimant had previous occurrences or been warned for similar conduct? *

If so, please provide the following for each warning: Date, type of warning (verbal/written/final), who gave it and the incident/reason for warning.

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