Resignation Notice & Final Pay Policy Acknowledgment
Submit your resignation and acknowledge the final pay policy for First-Rate Caregivers Health. Please review and complete all sections as applicable.
Employee Full Name
*
First Name
Last Name
Position/Job Title
*
Contact Information (Phone or Email)
*
Last Working Day
*
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Resignation
Please Select
Personal reasons
New job opportunity
Relocation
Health reasons
Family obligations
Other
Please explain your reason (optional)
I confirm that I am providing a written two-week notice of my resignation.
*
Yes, I am providing a two-week written notice.
I confirm that I will complete all scheduled shifts during my notice period.
Yes, I will complete all scheduled shifts.
Acknowledgments Regarding Final Pay Policy
I understand that if I do not provide a written two-week notice or do not complete all scheduled shifts during my notice period, my final pay may be adjusted to the applicable minimum wage for hours worked.
*
I acknowledge and understand this policy.
I understand that under no circumstances will my pay be reduced below the applicable federal or state minimum wage.
*
I acknowledge and understand this policy.
Conditions Where Pay Will Not Be Adjusted
I acknowledge that my pay will NOT be adjusted if:- I provide and complete a full two-week written notice,- My separation is due to a medical emergency or legally protected circumstances,- My employment is terminated by the company.
*
I have read and understand these exceptions.
Employee Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: