Fillable EMPLOYEE TERMINATION NOTICE (Coahoma Community College)

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EMPLOYEE TERMINATION NOTICE (Coahoma Community College)

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The EMPLOYEE TERMINATION NOTICE (Coahoma Community College) form is 1 page long and contains:

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  • 35 check-boxes
  • 17 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Coahoma Community College

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FOR PAYROLL USE ONLY
Stop Monthly Installments Effective _____________________________ Continue Monthly Installments Until ___ ____________________________
Benefits Cancelled: Life Insurance___________ Hospital Insurance ___________ Other ______________________ Cobra Packet Mailed Date_____________
Revised 4/1/99_
EMPLOYEE TERMINATION NOTICE
Employee Name Social Security # Employee Pin Number Today’s Date
Department
Job Title Last Date Worked Termination Date
( CHECK ONE ) FULL-TIME PART-TIME HOURLY SPECIAL PROJECT ABE /GED EVENING
TYPE OF SEPARATION
(CHECK ONE)
RESIGNATION (ATTACH LETTER OF RESIGNATION) DISMISSAL RETIREMENT LAY OFF
MUTUAL AGREEMENT PROGRAM/PROJECT ENDED REDUCTION IN FUNDS
REASON FOR TERMINATION (CHECK ONE)
VOLUNTARY QUIT POOR JOB PERFORMANCE INSUBORDINATION HEALTH RETIRED
POOR ATTENDANCE REDUCTION IN WORKFORCE FAMILY DISCHARGE FOR MISCONDUCT
EXCESSIVE TARDINESS OTHER _______________________________________________
RECOMMENDATION
(CHECK ONE)
WITHOUT RESERVATION WITH SOME RESERVATION WOULD NOT RECOMMEND
ELIGIBLE REHIRE?
YES NO IF NO, REASON:___________________________________________________________
ADDITIONAL COMMENTS:
_________________________________________
DEAN/DIRECTOR APPROVE
DISAPPROVE
_________________________________________
BUSINESS MANAGER
APPROVE DISAPPROVE
______________________________________
___
PRESIDENT APPROVE
DISAPPROVE
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EMPLOYEE TERMINATION NOTICE (Coahoma Community College)

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Completed 19 September 2020

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