Employment Separation Checklist
Employee Information
Name: __________________________________________________ _______
Employee ID: _______________________
Title:
____________________________________________________________________________________________________
Department/School: ________________________________________________
Grade: _____________________________
Union (If applicable): ________________________________________________________________________________________
Department HR Representative Name and Email: _______________________________________________________________
Date of Hire (mm/dd/yyyy): ____________________________
Last Day of Work (mm/dd/yyyy): ____________________
Termination Effective Date (mm/dd/yyyy): ______________________ (This date should be the next day after the last day of
work; for example, if the employee’s last day of work is June 30, then the termination effective date is July 1.)
TYPE OF SEPARATION:
□
Resignation
□
□
□
□
Involuntary:
Discharge
Release
Job Elimination
Retirement
□
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Was this termination reviewed and approved by CUMC Human Resources?
Yes
No (if no, provide reason):
____________________________________________________________________________________________________________
HR Client Manager Name and Email: __________________________________________________________________________
Next Steps
□
Process employee termination as soon as possible after being notified or after separation has been communicated to
the employee.
□
If system access is required to be shutdown prior to employee departing, please contact your HR Client Manager.
Voluntary Terminations and Resignation:
□
Process termination on E‐Term for Officers of Administration and Support Staff. For instructions on how to process
terminations via E‐Term, go to “Employment Termination on MSS and PAF” in the Manager Toolkit:
□
Submit a Personal Action Form (PAF) for Officers of Instruction, Officers of Research, etc.
□
Make sure that you have the employee’s resignation letter or confirmation of employee’s verbal resignation in your
department file as well as the employee’s vacation track record as part of the termination supporting documentation.
Retirement and Involuntary Termination (latter includes, Discharge, Release or Non‐renewal):
□
Submit a Personal Action Form (PAF) for job eliminations and retirement along with supporting documentation
(termination letter; letter of intent to retire; copy of separation agreement. For instructions on how to process
terminations via PAF, go to “Employment Termination on MSS and PAF” in the Manager Toolkit:
□
Severance pay: $_________________ (Severance pay must be reviewed and approved by your HR Client Manager prior
to communication with the employee). You must obtain all required signatures on layoff agreements within the allotted
1
period.
CUMC
HR Share Drive: CUMC Employment Separation Checklist‐ September 2011