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Employee Termination Form: Please Fill Out and Return To Your Payroll Specialist

This employee termination form is used to document an employee's termination from a company. It requests information such as the employee and company name, termination and last date worked, reason for termination from a provided list, any prior documented disciplinary actions, an explanation of the termination, and acknowledgement of notice by the employee and supervisor. A copy of the completed form would be distributed to relevant parties such as the employee, employee file, payroll provider, and benefits administrators.

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Tosin Openiyi
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841 views1 page

Employee Termination Form: Please Fill Out and Return To Your Payroll Specialist

This employee termination form is used to document an employee's termination from a company. It requests information such as the employee and company name, termination and last date worked, reason for termination from a provided list, any prior documented disciplinary actions, an explanation of the termination, and acknowledgement of notice by the employee and supervisor. A copy of the completed form would be distributed to relevant parties such as the employee, employee file, payroll provider, and benefits administrators.

Uploaded by

Tosin Openiyi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Employee Termination Form

Please fill out and return to your Payroll Specialist

Company Name: Date:


Employee Name: Social Security #:
Termination Date: Last Date Worked:

Reason for Termination:


Voluntary Involuntary
Resigned with Notice No Call, No Show Poor Performance
Moved Labor Dispute Laid Off
Retired Job Abandonment Violation of Policy
Resigned without Notice Relocated E-Verify Involuntary
Personal E-Verify Voluntary Transfer Company

Documented Disciplinary Action Prior to Termination (please provide copies):


Verbal Warning(s) Written Warnings None

Explanation (required):

Copy to: Employee Employee File National PEO Other:


Employee Benefits Health Dental Vision 401(k) Other:

Employee Acknowledgement:
My signature indicated that this notice has been discussed with me and that I understand its contents.

Employee Signature: Date:



Supervisor Name: Title:

Phone: 480.429.8098 Fax: 480.945.1525 www.nationalpeo.com

Rev. 1.1 Updated 05/2014

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