Separation Form
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1Upon Completion: Email Form
SEPARATION FORM
(MUST BE ATTACHED TO EMPLOYEE FILE)
Store #____________
Select one:
Terminated
Voluntary Quit
Employee Name ____________________________
Social Security # ________ _______ _________
Last Day Worked / Termination Date __________________
Reason for Separation: ____________________________________________
________________________________________
________________________________________
Rehire Status:
YES_____
NO_____
MANAGER SIGNATURE _________________________
DISTRICT MGR SIGNATURE ______________________
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Parent category: Business