Office Use: Termination Notice
Name of Employee
*
First Name
Last Name
Voluntary / Involuntary Termination
*
Voluntary
Involuntary
Last Day of Employment
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Termination Pay (if applicable)
Severance Pay (if applicable)
Please include pay rate and severance pay end date in above answer
Reason for Termination
*
Who is Completing this Form
By typing your name you are certifying that you have followed all required procedures for terminating this employee. Including but not limited to: budgetary approval, interviews, etc. You also certify that the above information has been completed to the best of your knowledge.
Submit
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