Employee Separation Report Store #Employee Name First Last Effective Date Date Format: MM slash DD slash YYYY Last Day Worked Date Format: MM slash DD slash YYYY Type of SeparationResignationDischargeAttend SchoolMovedDishonestyJob AbandonmentMilitaryPoor AttendanceUnacceptable Conduct/PerformanceDiscourtesy to CustomerOther (explain)Complete Details Regarding Termination:Did the employee give notice: Yes No Is employee eligible for re-hire? Yes No Employee SignatureDate Date Format: MM slash DD slash YYYY Manager/Supervisor SignatureDate Date Format: MM slash DD slash YYYY Use Your Browser Back Button to Return to Store Menu
