Termination Report

"*" indicates required fields

Name*

First Last

Location Worked*

Pick the store the employee was assigned

Last Day Worked*

Termination Date*

Type of Separation*

Quit / Resignation*

What reason did employee give for quitting?

Employee

Turned in keys

Turned in uniform

Missed scheduled shifts

Made no further contact

Quit / Resignation explanation

Please note any actions or comments by employee indicating intent to quit

Please identify what attempts were made to contact employee

Reason for Dismissal

Absenteeism / Lateness

Incompetence

Theft

Other

Please describe the final incident resulting in the dismissal of the employee

Written / Verbal Warnings

If Written warnings were given, verify that they have been sent to main office If verbal warnings were given, please identify: Date, Given by, and Work Issue

Other reason for Separation

Example: death of employee

Is this employee rehireable?*

Is this employee allowed to be rehired?

Manager Name*

First Last

File

Max. file size: 50 MB.

Signature*

Sign your name

Termination Report

Termination Report

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