I don’t know if this will fit your needs, I got this from the online template section of Microsoft Office.
I assume you could just re-word this as meets your needs.
Kristi
[Your Name]
[Street Address]
[City, ST ZIP Code]
[Current Date]
[Recipient Name]
[Title]
[Company Name]
[Street Address]
[City, ST ZIP Code]
Dear [Recipient Name]:
We regret to inform you that your employment with [Company Name] is being terminated, effective [date]. Your termination is the result of poor performance as outlined below:
• [Performance issue]
• [Performance issue]
• [Performance issue]
You were issued written warnings of these performance problems on [date], [date], and [date]. Copies of these warnings, signed by you, are in your personnel file. Your signature on each warning indicates that you discussed it with your manager, including steps you could take to improve performance.
As stated in your final warning, you needed to take steps to correct your performance by [date]. Your failure to do so has resulted in your termination.
To appeal this termination, you must return written notification of your intention to appeal to [Name] in Human Resources no later than [time] on [date].
Sincerely,
[Your Name]
[Title]
cc: [Manager Name]