Termination PAF

TERMINATION

BLS-HR-F-003
Payroll Action Request
Effective Date*

MonthDayYear
Date
Employee Information
Employee ID#*
Employee Name*

First NameLast Name
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
Position Information
Hire Date*
Job Title*
Direct Supervisor*
Location*
Department*
Shift*
Full TimePart Time
Payroll Classification*
Termination
Termination Option*
Termination Reason (Voluntary)*
Termination Reason (Involuntary)*
Eligible for Rehire*
PTO Payout
Termination Date*

MonthDayYear
Date
Termination Checklist
Corporate
Comments
Add a comment*
Include relevant information (ex. Low compensation, Disliked schedule, etc.)
Your Email*
example@example.com
Manager Email*
example@example.com
Signatures
Required
Date

MonthDayYear
Date
Supervisor Signature

Clear
Required
HR Representative Signature

Clear
Date

MonthDayYear
Date
If applicable
Executive Representative Signature

Clear
If applicable
HR Director Signature

Clear
Approver Information*
Should be Empty:

TERMINATION