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CITY OF LARAMIE, WYOMING DISCIPLINARY ORDER Name Department Date Type of Action: Written Reprimand Reduction in grade effective , 20 Suspension of days effective , 20 Dismissal effective , 20 REASONS: See Attachment Department Head APPEAL PROCEDURE: II. In the case of suspensions of more than three days or dismissals, the subject of such action may file a written reply to the City Manager within five days of receipt of the disciplinary order. III. In any action involving a change of status (dismissal or reduction in grade) or a suspension of more than ten (10) days, the subject of such action may file a formal appeal with the Personnel Board. This appeal: A. Must be in writing and must be addressed to the Personnel Board; B. Must be routed through the HR department; C. Must be signed by the individual who is appealing and include both his Department and grade therein; D. Must have attached thereto a copy of this disciplinary order; E. Must include basis of the appeal and detailed statement of facts in support of the appeal: F. Must be submitted to the Personnel Board within ten (10) calendar days of the receipt of this disciplinary order, but may not be submitted until the action complained of has become final when signed by the City Manager or his duly authorized representative). Hearings will normally be open to the public. However, the appellant may request that it be closed at the time he submits his written appeal. Further information with regard to appeal procedure may be found in the Appeal Process section of the City Handbook. Proof of Service Signatures: Approved or Disapproved Date City Manager