Fillable Termination Form (Oral Roberts University)

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Termination Form (Oral Roberts University)

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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.qYes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 that all company property must be returned on or before the last day of
work. The employee will personally check in library books and Aerobic Center combination lock. The Employee will turn in the
I.D. badge, hangtag, iPad, laptop, Employee Handbook, keys, Commercial Card/MasterCard and uniforms to Human Resources
where applicable.
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. 05172013
SECTION I - IMMEDIATE SUPERVISOR
SECTION II - PAYROLL
SECTION III - HUMAN RESOURCES
For Staff positions - send form to Human Resources. For Faculty positions - send form to the College Dean.
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Termination Form (Oral Roberts University)

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Completed 25 July 2020

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