Separation Notice

Employee Name: ___________________________________

Employee ID: ______________________________________

Position: ___________________________________________

Date of Separation: _________________________________

Type of Separation (Voluntary/Involuntary): ____________

Reason for Separation: ______________________________

Details of Separation (if applicable): ________________

Eligible for Rehire? (Yes/No): ________________________

Final Pay Details: ___________________________________

Employee Signature: __________________________________

Date: ________________________________________________

HR Signature: ________________________________________

Date: ___________________________________