Name:



|Employee Name: |Employee #: |Location |

|Effective Date: |Last Day Worked: |

|Termination Reason: |Eligible for re-hire? Yes No |

|Quit |Please give termination explanation: |

|Management Decision | |

|Reduction in Force | |

|Other_________________ | |

|Company Property: |Assigned |Returned |Comments |

|Vest | | | |

|Badge | | | |

|Key Fob | | | |

|Credit Card | | | |

|Cell Phone | | | |

|Laptop | | | |

|Other________________________ | | | |

|Other________________________ | | | |

|Supervisor/ |X |Date: |

|Manager | | |

For HR Use Only:

|Full-time | |401(k) | | |

|Seasonal |Pull I9 |Yes No |Notify Corp & GM |Remove from Security System |

| |

| |

| |

| |

[pic]

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download