Fillable Fm 105 Emp Termination

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Fm 105 Emp Termination

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EMPLOYEE TERMINATION NOTICE
IMMEDIATE SUPERVISOR is to initiate this form as soon as the supervisor knows of an employee terminating or being termi-
nated. The immediate supervisor completes Section 1, and forwards form to the Human Resources Department. If employee is
resigning, attach a signed resignation letter.
Employee Name Company
Z Number Department Organization Number
1. Employee’s last workday will/was _______________________________________________________________________ (date)
If termination occurs while employee is on paid leave, give the employee’s last paid day. ____________________________ (date)
2. Status: q Full-time q Part-time q Seasonal/Task
3. q Voluntary q Involuntary
4. Termination code:
A. Another job F. Stay home K. Military service P. Job performance
B. Job dissatisfaction G. Job abandonment L. Health Q. Other ______________________
C. Conictw/supervisororpeers H. Returntoschool M. Retirement ______________________
D. Marriage I. Misconduct N. Death ______________________
E. Pregnancy J. Reductioninforce O. Layoff ______________________
5. Would you re-employ in your dept? q Yes q No If “No”, please attach a memo, stating reasons.
6. If“ReductioninForce”,issalarycontinuationtobegiven?q Yes q No
7. If employee resigned, did he/she give notice? q Yes q No If “Yes”, how much notice? ________________________________
8. Resignationletter,ifapplicable,shouldbeattachedtoEmployeeTerminationNotice.
9. Employee has been issued a Commercial Card/MasterCard. q Yes q No
10. EmployeehasoutstandingexpenseadvancesfromOralRobertsUniversity.q Yes q No
11. Employee’smovingexpenseswerepaidbyOralRobertsUniversityuponhire.q Yes q No
12. Employee’scostofschoolingand/ordependents’tuitionwaspaidinwholeorpartbyOralRobertsUniversity.q Yes q No
13. Employee was assigned computer/email access. q Yes q No
14. If employee is being inducted into the Armed Services, show branch and date: _________________________________________
15. ForwardingaddressforW2,COBRA,etc.: _____________________________________________________________________
NOTE: Immediate supervisor will notify the employee to return all company property to Human Resources on or before the last
day of work. Company property may include the following: keys, I.D. badge, IPad, laptop, hangtag, commercial credit card and/
or uniforms. ORU Library books will be returned by the employee to the Library.
16. Immediate Supervisor ______________________________________________________________________________________
Signature Date
1. qVacationtime,ifapplicable,hasbeencalculatedfornalpaycheck.
2. q Promissory notes, expense advances, or other debts outstanding have been accounted for.
Payroll Department ___________________________________________________________________________________________
Signature Date
1. q Final paycheck was mailed to employee on ______________________________ (date)
HumanResourcesRepresentative _______________________________________________________________________________
Signature Date
FM105 Rev. 06192014
SECTION I - IMMEDIATE SUPERVISOR
SECTION II - PAYROLL
SECTION III - HUMAN RESOURCES
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Fm 105 Emp Termination

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Completed 27 February 2020

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