Language
English (US)
Spanish (Latin America)
Employee Termination
This form is to submit notice of termination of an employee's work, due to lay off, voluntary or involuntary resignation.
Business Name
*
Employee Name
*
First Name
Last Name
Employee Email
*
example@example.com
Client/Supervisor Submitting Form
*
First Name
Last Name
Client Email
*
example@example.com
Termination Effective Date
*
-
Month
-
Day
Year
Date
Regular Hours to be Paid on Final Check
Vacation Hours to be Paid on Final Check
Reason for Termination (Voluntary)
Secured better position
Dissatisfied (supervisor)
Dissatisfied (type of work)
Dissatisfied (working conditions)
Dissatisfied (salary)
Generally dissatisfied
Retirement
Returned to school
Moving out of area
Family or personal circumstances
In Lieu of Discharge
Other
Reason for Termination (Involuntary)
Absenteeism or tardiness
Failure to meet performance expectations
Insubordination
Gross misconduct
Dishonesty or theft
Job abandonment
Not qualified for position
Death
Other
Layoff
Lack of Work
Job eliminated
COVID-19
Other
Reason for Leaving (Supervisor's Statement)
*
Eligible for Rehire?
*
Yes
No
Other
If no or other, please describe
*
I have been hired as an at-will employee of MyPEO, which is an employee leasing company.
Employee Signature
Today's Date
-
Month
-
Day
Year
Date
Client Signature
*
Today's Date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
Save
Submit
Submit
Should be Empty: