Corporate employee - please return to:
Site employee - please return to:
Payroll - Team 05
Human Resources and Workforce Development
Shared Services SA
HR Services - Preschools and Schools
Courier R11/15 or DX 703
GPO Box 11026
GPO Box 1152
Ph: (08) 8462 1305 (press 1)
Ph: (08) 8226 1356
Fax: (08) 8124 9605
NOTICE OF RESIGNATION OR RETIREMENT OF A DEPARTMENT EMPLOYEE
Section 1: EMPLOYEE DETAILS
for communications and forwarding
payment summaries etc.
Nominated resignation/retirement date
If “Yes”, indicate dates
Are you currently on leave?
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.
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)
Section 2: TO BE COMPLETED BY LINE MANAGER
Section 3: DELEGATE APPROVAL
For processing of termination
1. Resignation / Retirement approved from
2. Long Service Leave pursuant to Section19 & 21 of the
Education Act, 1972
RR0141 - Termination of Employee completed