EMPLOYEE EXIT CHECKLIST
Employee Name:
…………………….
Job Title:……………………………
Department:………………………………………….. Last Day Worked:…………………………
Reason for Exit (circle one):Resignation Retirement Layoff Discharge Job Abandonment
Other:…………………………………………………………………………………………………..
The following checklist is provided to assist employee and supervisor with the exit process.
□ = Task Completed
NA = Not Applicable
Human Resources
□
F
inal p
aycheck
(include any accrued but unused vacation hours
)
□
Lett
er of Resignation (if applicable
)
□
Pull files (personnel, benefits,
medical, etc.)
□
Get updated address for W2
□
Other
:
Access Cancellation
□
Retrieval of passwords
□
Disconnect computer access
□
Email address removed from staff list
□
Desk area cleaned out
□
Other:
Company Property to be Returned
□
I.D.
Badge
□
Company
Laptop
□
Company
Credit
Cards
□
Building
Keys
□
Uniforms
□
Other:
Review With Employee
Agreements:
□
Non
Disclosure Agreement
□
Non
compete Agreement
Benefits
□
COBRA
Enrollment Application (for continued medical benefits coverage)
□
EDD for Your Benefit (Form
DE
2320)
□
Notice to Employee as to Change in Relationship (not employees resigning)
Employee’s Signature
Date Completed
Supervisor’s Signature
Date Completed
NOTE
:
Place a signed copy in employee’s fil
e