Employee Exit Checklist - Mississippi University

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Employee   E xit   C hecklist  
Name  
Pers   N o  
Position  
Date   o f   S eparation  
Department  
Supervisor  
Mailing   A ddress  
Is   e mployee   t ransferring   t o   a nother   U niversity   d epartment?      
¨     Y es  
¨     N o  
Is   e mployee   t ransferring   t o   a nother   s tate   a gency,   j unior   c ollege,   o r   U niversity?    
¨     Y es  
¨     N o  
If   s o,   w hen:  
and   w hich   a gency  
The   U niversity   o f   M ississippi   h as   t he   a uthority   t o   d educt   f rom   a n   e mployee’s   f inal   c heck   a ny   u npaid   a mounts   f or  
property   w hich   w as   n ot   r eturned,   a ny   o verpayment   o f   w ages,   a nd   a ny   o ther   u npaid   d ebts   t o   t he   U niversity.  
EMPLOYEE:     P lease   r eturn   t he   f ollowing   i tems   t o   y our   D epartment   H ead   o r   h is/her   d esignee:  
Item  
Date   R eturned  
Applicable   U M   P roperty   N umber  
Parking   H angtag   ( Dept:   R eturn   t o   P arking   &   T ransportation)  
Building/Office/Vehicle   K eys   / cards   ( Dept:   R eturn   k eys   t o   P PD)  
University   I D  
Departmental/Office   E quipment   o n   L oan   ( attach   l ist)  
Cards:     P rocurement,   A merican   E xpress,   a nd   G as  
Uniforms  
Books/Materials   ( attach   l ist)  
Other   U M   p roperty   ( attach   l ist)  
SUPERVISOR:     P lease   i ndicate   w hether   t he   a ppropriate   a ction   h as   b een   t aken   ( attach   s upporting   d ocuments):  
Cancelled:  
YES  
N/A  
Comment  
SAP   a ccess   ( sap@olemiss.edu)    
¨  
¨  
E-­‐forms   a ccess   ( rbjohnso@olemiss.edu)  
¨  
¨  
PeopleAdmin   / jobs.olemiss.edu/hr   a ccess   ( hr@olemiss.edu)   ¨  
¨  
Home   I nternet   A ccess   P rovided  
¨  
¨  
Departmental   C redit Card    
¨  
¨  
Departmental   L ong   D istance   C ard   ( telcom@olemiss.edu)  
¨  
¨  
Personal   L ong   D istance   C ard   ( telcom@olemiss.edu)  
¨  
¨  
Access   s wipe   c ard   ( idcentersupport@olemiss.edu)    
¨  
¨  
Contacted:  
Accounting   O ffice   t o   c hange   S ignatory   A uthority  
¨  
¨  
  OSRP   a nd   D ivision   H ead,   i f   e mployee   i s   a   P I/PD  
¨  
¨  
Changed:  
Passwords   ( on   s ervers   a nd   c omputers)  
¨  
¨  
Property   O fficer   ( if   D ept   H ead,   a udit   m ust   b e   p erformed)  
¨  
¨  
Petty   C ash   R esponsibility   T ransferred   a nd   C ash   A udited  
¨  
¨  
Completed:  
Eform   3   f or   s eparation  
N/A   f or   “ Transfer”   o nly  
¨  
¨  
Return   a   c opy   o f   t his   f orm   a nd   t he   E mployee’s   U niversity   I D   t o   H uman   R esources.  
Employee   S ignature:  
Date:  
Department   H ead   S ignature:  
Date:  
Rev   O ct   2 014  

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