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ACKNOWLEDGMENT OF WORK RULES

Employee name:

Employee number:

Department:

Social Security number:

I have read and understand the company work rules. I acknowledge that I am expected to conform to those rules and that I am subject to termination for failure to conform to the said rules. It is understood that any modification to the work rules must be in writing and signed by [individual with the authority to modify work rules]. In addition, I acknowledge that I have a duty to report to [supervisor] any violations of the work rules by other employees.

Acknowledged by:

Date:

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