Exit Checklist Form
Track and confirm completion of all required offboarding tasks for departing employees in a clear, minimal format.
Employee Full Name
*
First Name
Last Name
Department
*
Please Select
Engineering
Product
Sales
Marketing
Finance
HR
Operations
Other
Last Working Day
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Company Property Returned
Laptop/Computer
Access Card/Badge
Mobile Device
Other Equipment
Access Revoked
Email Account
Internal Systems
Building/Facility Access
Exit Interview Completed
Yes
No
Not Applicable
Final Payroll Processed
Yes
No
Not Applicable
Forwarding Contact Provided
Yes
No
Manager/HR Notes
Form Completed By
*
First Name
Last Name
Submit Checklist
Should be Empty: