Employee Termination Checklist
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1Employee Termination Checklist
Employee Name: __________________________________________________________________________________
Supervisor:_______________________ Dept: ________________ Account #: ________________________________
Forwarding Address (if changed):
________________________________________________________________________________________________
Phone number: Day: (
) __ __ __ - __ __ __ __
Eve: (
) __ __ __ - __ __ __ __
Last day worked: ________________
Instructions: Please put your initials and the date next to the action that has been taken.
Voluntary Termination
Involuntary Termination
(Steps to follow)
_________ Obtain resignation in writing from Employee
__________ a) Corrective action followed (if applicable)
__________ b) Explanation provided to employee
Other
(Death, Military)Reason _______________
__________ c) Human Resources reviewed information
_________ Received supporting documentation
__________ d) Letter of termination including reasons
Review With Employee
Collect
_________Effective Date of Termination
__________ Key Fob
_________Final wages
__________ All keys (locker, bldg, desk,
cabinets, etc)
Check to be direct deposited
__________ Final Timesheet
Check to be picked up
Where?_______
Check to be mailed
Where?_______
__________ Cellular phones
__________ iPad
_________Benefit pay (if applicable)
__________ Laptop computer
Accrued time off
__________ Parking tag
When received
__________ ID card
_________ Benefits information summary
__________ Reference/Training/Manuals
_________ Rehire eligibility:
__________ Any proprietary materials/
Y
N
property
_________ How references will be handled
_________ Subsequent access to premises
Give to Employee (Optional)
Cancel
_________ Exit Interview
__________ Computer access
_________ Benefits information (COBRA, etc)
__________ TSIS
_________ Contact information for HR
__________ Remove from phone list – dept.
__________ Cancel email
Other
__________ Benefits (CHS)
_________ Clean work area, remove personal belongings
__________ Direct Deposit
_________ Process Termination (HR, Payroll)
__________ Lunch Account
Notes:
Signature of Supervisor and Date:
_____________________________________________________________________
Supervisor should complete form and notify other areas as appropriate to ensure that all parts of the
checklist are completed. Return form to HR when complete.
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Parent category: Life