Fillable Form to be completed by department: Department Checklist (University of Alabama at Huntsville)

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Form to be completed by department: Department Checklist (University of Alabama at Huntsville)

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The Form to be completed by department: Department Checklist (University of Alabama at Huntsville) form is 1 page long and contains:

  • 3 signatures
  • 16 check-boxes
  • 18 other fields

Country of origin: US
File type: PDF

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Revised June 2020
Department Checklist For Terminating Employees
Form to be completed by department
Name: _________________________________________________ Banner ID (A#): __________________________________________
Phone Number: _________________________________________________ Department: __________________________________________
Forwarding
Email Address: _________________________________________________ Job Title: __________________________________________
Forwarding/
Mailing Address:_________________________________________________ Date of Separation: __________________________________________
_________________________________________________
_________________________________________________
Please complete this form for employees that are terminating employment with the University. This ensures that the University property has been returned
and computer access has been disabled. Please complete the contact information, address, phone number and email of the employee in the above spaces. If
the employee is moving from the area, please list their forwarding address.
DEPARTMENT CHECKLIST
1.
Immediate Supervisor/
Department Head*
*Requires both signatures if not the
same person. Report computer
access to OIT Help Desk at
824.3333.
** Obtain property list from
Asset/Inventory Management at
crb@uah.edu or call 824.6315.
All departmental property accounted for**
All keys to University facilities returned
Office of Information Technology (OIT)*
Corporate/Procurement credit cards
returned to Business Services
Employee ID card returned to department and shredded
Is the employee sponsored by UAH for employment work authorization (H1B, J1 VISA)? Yes No
If yes, employee needs to call 824.6055 to schedule an appointment.
Does this employee hold a security clearance with Research Security? Yes No
If yes, employee needs to call 824.6444 or 824.6048 to schedule an appointment.
Is the employee considered key personnel or Principal Investigator on a research contract, grant or award?
Yes No
If yes, employee needs to call 824.2647 or 824.2657.
Is this employee responsible for a Lab, Studio, Shop or Stockroom? Yes No
If yes, employee needs to call 824.2171 to schedule an appointment.
Has the employee completed their final timesheet? Yes No
2. Department Staff Assistant
Final ePAF prepared
Immediate Supervisor/
Department Head
*: ___________________________________ Department Staff Assistant: ______________________________
Signature and Date Signature and Date
Email the
completed form to benefits@uah.edu. To support the limiting of in-person interactions, these employees do not need to go to each functional
area in order to complete the check
-out process. We will contact the appropriate functional areas by phone and/or email to obtain the necessary
clearance.
We will also contact the employee directly if there are any questions or concerns regarding their separation.
3. HR Benefits Office
Employee exit report obtained (staff employees only)
Verification from Library
Verification from Research Security
Verification from OSP
Verification from EHS
Verification from Payroll Services
Bursar’s Office
Released of final check authorized
HR Benefits Office:
____________________________________
Signature and Date
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Form to be completed by department: Department Checklist (University of Alabama at Huntsville)

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Completed 28 August 2020

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