Staff Resignation/retirement Notice Form printable pdf download

Staff Resignation/retirement Notice Form

STAFF RESIGNATION /RETIREMENT NOTICE

Employees are expected to give their supervisor written notice at least two weeks before

leaving employment from the First Regional Library. The library requires that this written

notice include the employee’s reason for leaving employment, the last day to be worked

(which may be different from the last day of employment), and forwarding address for

purposes of sending the last check and /or W-2 forms. All separation notices are to be

forwarded to the Business Office. Keys must be returned and library record cleared

before last pay check issued.

Name of Employee: _____________________________________________________

Branch Name or Work Location:____________________________________________

Last Actual Day at Work: _________________________________________________

Effective Date of Termination:_____________________________________________

Reason for leaving (continue on back if needed):

______________________________________________________________________

_______________________________________________________________________

Forwarding Address:

_______________________________________________

________________________________________________

Comments (continue on back if needed):

________________________________________________________________________

Employee Signature: ____________________________ Date Submitted: ___________

Supervisor Signature: ___________________________ Date of Acceptance_________

Please Forward to Business Office ASAP

Business Office: ________________________________ Date Received_____________

Key(s) returned________ Library Record cleared________Staff Orders paid_________

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Staff Resignation/retirement Notice Form