EmployeeID (Trinet)

Check here i

(

Signature

This form must be filled in the full desktop version of Adobe. DOWNLOAD

Mail to

Instructions for use of this formPlease utilize this document to notify within 24 hours of the separation of an employee. This includes both voluntary (resignation) as well as involuntary (termination) separations.

SPECIAL PAY: Severance, Vacation, and Pension must be submitted with your next payroll or as a separate supplemental payroll run.

PAY CHECKS ISSUED TO EMPLOYEES AFTER THEY HAVE BEEN TERMINATED WILL ALWAYS BE LIVE CHECKS.

Form submission for paper forms:

•• Please attach any accompanying documentation and retain a copy for your files.

DISCHARGED QUIT LACK OF WORK02 Refused Instructions 20 Domestic Obligations 48 No Light Duty Available05 Falsified Application 21 For Other Work 50 Location Closed08 Neglect of Duty 23 Without Notice 51 Job Eliminated09 Misconduct 24 Job Dissatisfaction 52 End of Temporary Assignment10 Violated Company Policy** 25 Personal Reasons 56 End of Seasonal Work11 Unexcused Absenteeism 27 Moved 58 Lack of Work12 Unexcused Tardiness 29 Other Voluntary Quit13 Insubordination 32 Refused Recall17 Work Quality/Quantity 39 Reduced Work Schedule18 Shortages 60 Voluntary Retirement19 Dishonesty 66 Not Able/Available71 Refused Work 85 Deceased76 Violation of Drug/Alcohol Policy

Notice of Employee Separation Instructions