Leavers Form - Operational & Maintenance Staff
To be completed and returned to your Human Resources Team
(Note: This form is only for staff leaving ALL employment of the University)
* NAMES MUST BE PRECISELY AS SHOWN ON OFFICIAL DOCUMENT e.g. PASSPORT
Title ………… First Name ....................................................... Middle Name(s) …………………….…………..
Preferred First Name …………………………………………… Personnel number ……………………………..
Surname (Last name) ............................................................. Date of Birth…………………….......(DD/MM/YY)
Service Unit: ..…………………………………………….….……………….…. Extension:….………
Total contracted hours per week: ………………………………………………………………..
Last day of University employment:………………………………………………………………
Last day actually worked: …………………………………………………………………………
* The outstanding holiday entitlement to be paid
with the employee’s final settlement pay is:…………………….. days
* The number of outstanding lieu days to be paid
with the employee’s final settlement pay is:…………………….. days
(* Please do not quote these figures in the acknowledgement letter.)
FOR COMPLETION BY LINE MANAGER OR HEAD OF SERVICE UNIT
Name (please print): …………………………………………..
Signature: ……....………………....……..........
P45 and Pensions
Please confirm your forwarding correspondence address (even if you think it is the same
address already held by the University). Your P45 will automatically be posted to this
address. P45s CANNOT be re-issued or duplicated.
Forwarding Address
………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
Postcode………………………………
Please ensure you contact Payroll (Pensions-enquiries@ncl.ac.uk) as soon as possible if
you are a member of a pension scheme. There may be time limits associated with the options
available to you upon leaving the scheme.
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Leavers Form – Operational & Maintenance Staff
April 2015
Leavers Form - Operational & Maintenance Staff
What are your reasons for leaving the University?
Resignation
Moving out of area
Difficulty travelling to work
Relationships at work (combines colleagues & manager)
Seeking more job satisfaction
Seeking better career prospects/training & Development
Seeking higher salary
Lack of recognition/job satisfaction
Other - please state……………………………………………………
Retiring
On grounds
of ill-health
Retiring
on grounds
of ill health
End of Fixed Term Contract
For HR Use:
The following information is required for the Higher Education Statistics Agency (HESA)
What will be your location after leaving? Tick one only
England
UK(not otherwise specified)
Wales
Other EU
Scotland
Non-EU
Northern Ireland
Information Refused
What will be your activity after leaving? Tick one only
Working in an HE Institution
Working in the private sector
Working in another educational institution
Registered as a student
Working in a research institute (private)
Self-employed
Working in a research institute (public)
Retired
NHS/general medical practice/general dental practice
Not in regular employment
Working in another public
sector organisation
Working in the voluntary sector
Exit Questionnaire
Your feedback is really important to us and what you tell us about your experiences of working at Newcastle
University can help us to improve our employment policies and practices for staff in the future. Our Exit
Questionnaire is available at http://www.ncl.ac.uk/hr/policy/leaving/index.php
Termination of IT Services and Facilities for Leavers:
Access to corporate business systems such as SAP will terminate on the last day of the employment
contract for all staff. For support staff, access to University IT Services, including email and web access,
will normally be terminated on the last day of the employment contract.
Smart Card, keys and other University property are to be handed in to your manager or appropriate person
before you leave.
For further information please refer to the policy.
Signature of leaver:
............................................. ……..
Date: ...........................................
If you wish to discuss anything further relating to your departure, please contact your HR team.
Page 2 of 2
Leavers Form – Operational & Maintenance Staff
April 2015