HR Demotion Notice

HR DEMOTION NOTICE

Employee Information

Position Information

Current Job Title:    Department:

Reporting Manager:    Date of Hire:

Prior (Pre-Demotion) Title:    New (Post-Demotion) Title:

Effective Date of Demotion:    Employment Status: Permanent Temporary    If temporary, Expected Review Date:

Reason for Demotion (Check all that apply)

Performance deficiency documented by prior performance reviews
Misconduct or violation of policy
Organizational restructuring or business needs
Medical/fitness for duty considerations
Voluntary position change requested by employee
Other (specify below)

Summary of Circumstances

Provide a concise factual summary of the circumstances that led to the demotion (include dates of counseling, performance reviews, incidents, or organizational actions):

Changes to Terms of Employment

Base Salary (Pre-Demotion): $    Base Salary (Post-Demotion): $

Pay Rate Change Effective:

Benefits Impact: Health insurance change Retirement/401(k) change Leave accrual change

Duration and Review

This demotion is: Permanent Temporary

If temporary, anticipated review and decision date:

Employee Rights and Appeal Procedure

The employee may submit a written appeal disputing this demotion to Human Resources within 7 calendar days of receipt. The written appeal should outline specific factual or procedural errors and include any supporting documentation. The employer will acknowledge receipt of an appeal in writing and will respond after a documented review. Nothing in this notice limits rights under applicable law.

HR Contact for Appeal:    Phone:

Employment History (Most Recent Employers)

Title:    Dates Employed:

Title:    Dates Employed:

Education

Professional References

Phone:    Email:

Phone:    Email:

Phone:    Email:

Legal Disclosures

At-Will Employment: Nothing in this notice modifies the at-will nature of the employment relationship unless expressly documented in a separate written agreement signed by an authorized company representative. Either the employer or the employee may terminate employment at any time for any lawful reason.

Equal Employment Opportunity: The employer prohibits discrimination or retaliation on the basis of protected characteristics. This demotion has been documented in accordance with applicable nondiscrimination laws and company policy.

Authorization and Acknowledgments

Payroll Adjustment Authorization: By signing below, the employee acknowledges that any necessary payroll adjustments, benefit modifications, or related administrative changes resulting from this demotion will be applied effective the date specified above.

Authorization to Contact: The employee authorizes Human Resources to contact prior employers and listed references for verification and for any employment-related investigations necessary in connection with this personnel action. I authorize contact

Employee Certification and Acknowledgment

I certify that I have received this Demotion Notice and that the information provided above is accurate to the best of my knowledge. I acknowledge that I have been provided the reason(s) for this demotion and information about the appeal process. My signature below does not necessarily indicate agreement with the decision; it indicates receipt and acknowledgment.

Employee Initials:

If the employee declines to sign this notice, manager or HR must indicate reason below and sign.

Sign Now