Leavers Form
For completion by the line manager. This form once submitted is automatically sent to the CRM & Systems Manager & The People and Administration Manager to action your request.
Details
Resignations must be received in writing and filed on the Employees BreatheHR record
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Name of staff member leaving
*
First Name
Last Name
Job Title
*
Termination date agreed
*
/
Day
/
Month
Year
Date
Last working date agreed
*
/
Day
/
Month
Year
Date
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Arrangements for leaving
Will pay adjustments need to be made to payroll for annual leave?
*
Yes, the employee has taken more leave than accrued to their termination date and will have this deducted from their final pay
Yes, the employee will be paid for leave that has been accrued and not taken
No, any remaining leave accrued will be taken before termination date
Would you like a leavers ecard to be circulated for colleagues to sign?
Please Select
Yes
No
An ecard can be sent after the Line Manager has circulated an email to all staff giving details of the leaving date.
The staff member's laptop, monitor, phone, cables, and chargers will be collected. Are there any further arrangements or changes of address?
*
Please include details of the equipment and resources that require collection from the staff member and any changes to the address that these should be collected from.
The staff member should have a box for both the monitor and laptop, in good condition, and not damaged. Please check with them as these boxes are passed between staff members and should be in an acceptable condition.
*
No new boxes needed
x1 New Laptop Box
x1 New Monitor Box
Other
What date should the equipment be collected? NB: We can only control the courier date, not time. So if a staff member finishes on the Friday, are you sure you want that equipment collected on the Friday as the courier may well collect at 9am. You may prefer the following Monday etc.
*
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Month
/
Day
Year
Date
Date of Exit interview
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Month
-
Day
Year
Please add details of the exit interview to the employees BreatheHR record
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IT Access changes
On what date should system access be removed?
*
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Month
-
Day
Year
Date
Outlook mailbox arrangements
*
Convert to Shared Mailbox - all existing email and calendar appointments are retained. Nominated users can access the mailbox and calendar.
Forward emails to another mailbox - new emails to the leavers mailbox will be received by a nominated user
Delete mailbox - all existing emails and calendar entries are deleted. Emails sent to the leavers email address will not be received.
Name(s) of employees nominated for shared mailbox access or to receive forwarded emails
Individual's Personal YGAM OneDrive Storage access
Files held on the users OneDrive account will be saved in a secure area of Sharepoint. Please give details of which YGAM employees are nominated to have access to these files.
Other systems to be updated they have access to
Please give details of any other systems or portals that the employee has login access to including Salesforce, Adobe Creative Cloud, Website & social media pages and any other relevant YGAM accounts.
Any other information
Please include any other relevant information here
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