Employee Separation Form
Please fill-up the form accordingly. If you have any questions, please contact (123) 123-4567 or email us at info@email.com.
I. Employee Information
(To be filled out by the Employee)
Name
First Name Last Name
Job Position
Department
Employee ID
Email
example@example.com
Phone Number
Area Code Phone Number
Status
Full-Time Part-Time Temporary
Separation Date
Month Day Year
Date
Reason for separation
Resignation Termination Retirement
More details about the separation
II. Employer Information
(To be filled up by the Manager/Supervisor)
Manager/Supervisor Name
First Name Last Name
Phone Number
Area Code Phone Number
Email
example@example.com
When was the notice of resignation received?
Month Day Year
Date
Comments/Remarks
Manager/Supervisor Signature: By signing below, you are accepting the resignation of this employee
Clear
III. HR & Payroll
(To be filled out by the HR and Payroll)
Number of leaves available for credit
Please upload the final time sheet to be credited for final pay
Browse Files
Cancelof
Would you rehire?
Yes No
Final pay will be credited via
Direct deposit Mail Payroll
Comments/Remarks
HR Officer Signature
Clear
Payroll Officer signature
Clear
Should be Empty: