Resignation in Lieu of Termination Report Form
Use this form to report a resignation that occurred instead of a termination. All sections are required for accurate recordkeeping.
Employee Full Name
*
First Name
Last Name
Employee Position/Title
*
Department
*
Please Select
Human Resources
Finance
Operations
Sales
Marketing
IT
Other
Supervisor/Manager Name
*
Date of Resignation Notice
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Last Working Day
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Resignation
*
Personal reasons
Better opportunity elsewhere
Job dissatisfaction
Work environment
Performance concerns
Other
Brief Description of Circumstances
*
HR Representative Name
*
Date of Report Submission
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Report
Should be Empty: