Marshall Hatchick Two Counties Championship Disciplinary Report on Player(s) by Panel Umpires Teams: v Division: Date: Reported person and Club: Time and date player notified of the breach: Captain at time of the alleged incident: Names of those present when the player was informed: Report: Offence Level 1 2 3 4 (Please circle) Describe the incident – a brief, factual, account of the details of the alleged breach of the Code of Conduct or other alleged offence: Umpire’s name Umpire’s name Signed (by player(s) notified of the breach): Top copy to League Secretary within 2 days of the game, 1 copy to captain and 1 copy to a club official on the day. In addition for Level 2 to 4 Offences a full report agreed and signed by both umpires should be sent the League Secretary within 2 days of the offence. Reports can be emailed to the League Secretary at allison.twocounties@yahoo.co.uk CLUBS HAVE 7 DAYS TO RESPOND TO THE LEAGUE SECRETARY AND TO TAKE ACTION AGAINST THE PLAYER USE BLACK PEN ONLY TO FILL IN THE FORM