Free Disciplinary Action Form 23Free Disciplinary Action Form 23
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State of Maryland
Department of Budget and Management
Office of Personnel Services and Benefits
301 West Preston Street
Baltimore, Maryland 21201

To Employee: You or your representative may appeal this disciplinary action to the Cabinet Secretary of your
department (if your agency is not headed by a Cabinet Secretary, appeal must be made to
the agency head). The appeal must be in writing and filed within 15 calendar days after
your receipt of this written notice.
------------------------------------------------------------------------------------------------------------------------------------------------To Agency:
COMPLETE IN DUPLICATE. Give one copy to the employee; and retain one copy for
your files. Please do not send copy to Department of Budget and Management.
This action must be processed via the DBM Office of Personnel Services
and Benefits electronic Statewide Personnel System (SPS).