WOR-Off Boarding Form

Employee Off-boarding

End of Employment Documentation

Date(Required)

Today's Date

Last Day Worked(Required)

Please enter the last day this employee worked for the company.

Final Paydate(Required)

Please enter the final pay-date for this employee. This will be the Friday of next week. Pay cycles are Monday - Sunday and are payed the following Friday of every week. Note: If this employee was terminated, please enter the final pay date as the next day, regardless of what day it falls on.

Employee Name(Required)

First Last

Name of employee being off-boarded

Employee's Email(Required)

Please ask for the email address that most likely will remain in use until March of the following year. This is where Form W2 (Tax Return Information) will be emailed too. A copy of this document will also be sent to this email address.

Why is this employee being off boarded?(Required)

Please complete this field as thoroughly as possible.

Was sufficient notice provided by the employee?(Required)

Does this employee qualify for rehire?(Required)

Do you feel that this employee would be a good candidate for rehire? If this employee was terminated, please select no.

Has the employee returned any items for reimbursement?

Shirts with company logo?

Aprons with company logos

How many shirts were returned?(Required)

Please enter the number of ACCEPTABLE shirts with company logo were returned.

Total reimbursement for shirts.

How many aprons were returned?(Required)

Please enter the number of ACCEPTABLE aprons with company logo were returned.

Total reimbursement for aprons.

Total reimbursement to be paid on final pay.

Verification(Required)

By checking this box, the manager listed below has completed this exit document with the employee, or in the event the employee has been terminated and does not want to complete this document, the manager will note this below.

Manager/Supervisor completing this exit document(Required)

First Last

Manager/Supervisor Signature(Required)

Date Manager/Supervisor Signed(Required)

Employee Comments

Please provide any comments or information you would like considered in the event you re-apply for employment.

Employee Signature

Date Employee Signed

Comments

This field is for validation purposes and should be left unchanged.

Employee Off-boarding

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