Notice Of Resignation Or Retirement Of A Department Employee
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1
2VL156
Corporate employee - please return to:
Site employee - please return to:
Payroll - Team 05
Human Resources and Workforce Development
Updated 11/15
Shared Services SA
HR Services - Preschools and Schools
Courier R11/15 or DX 703
Courier R11/10
GPO Box 11026
GPO Box 1152
Adelaide 5001
Adelaide 5001
Ph: (08) 8462 1305 (press 1)
Ph: (08) 8226 1356
Fax: (08) 8124 9605
Email: DECD.leave@sa.gov.au
Payroll05Documentation@sharedservices.sa.gov.au
NOTICE OF RESIGNATION OR RETIREMENT OF A DEPARTMENT EMPLOYEE
Section 1: EMPLOYEE DETAILS
Family
Given
Person ID
Name
Name(s)
Location
Location Number
Job Title
Classification
Telephone
E-mail
for communications and forwarding
Address
Postcode
payment summaries etc.
Nominated resignation/retirement date
If “Yes”, indicate dates
Are you currently on leave?
dd/mm/yyyy
No
to
Yes
Reason for ceasing duty
If resigning, please provide the specific reason.
(eg. retirement, resignation - refer to page overleaf for termination reason).
I would like an exit interview and/or complete
*Refer to page overleaf.
Yes
No
VL153 Employee Exit Report*:
If “Yes”, please negotiate this with your line manager.
I intend to retire or resign and hereby apply for any leave accruals and/or salary owing to me.
(Signature of Employee)
(Date)
Section 2: TO BE COMPLETED BY LINE MANAGER
(Signature)
(Print Name)
(Position)
(Date)
Section 3: DELEGATE APPROVAL
For processing of termination
(Name)
1. Resignation / Retirement approved from
(dd/mm/yyyy)
Without Penalty
(Delegate Signature)
(Date)
With Penalty
No. Days:
ENTERED BY
CHECKED BY
2. Long Service Leave pursuant to Section19 & 21 of the
Education Act, 1972
/
/
/
/
RR0141 - Termination of Employee completed
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