COMPANY NAME
Employee Name Term Date:
Checklist completed by: Date:
TERMINATION CHECKLIST
Following is a checklist of items that must be completed prior to or on the last day with COMPANY:
- General — Manager and Human Resources
____ Voluntary — Give written resignation letter to supervisor with a copy to Human Resources
____ Involuntary — Statement and/or documentation to the file regarding termination
____ Conduct the exit interview
____ Notify Network Administrator to terminate access to computer, e-mail, voice mail, etc.
- Items to Return, where applicable
____ Office keys/cards (front door/building, office, gym facility)
____ Corporate credit card name and #
____ Parking pass or metro pass
____ Equipment/property: (Employee Handbook, software, cell phone, laptop, etc.)
List tems:
III. Payroll
____ Obtain forwarding address (for W-2)
____ Note any outstanding expenses (expense checks, advances, relocation expenses):
____ Review leave reconciliation (vacation/PTO)
____ Obtain final signed timesheet and inform when final paycheck would be sent
____ Process status change/payroll form and send to Payroll
- Benefits — Human Resources
____ Notify of COBRA continuation of health, dental
____ Provide and/or mail COBRA letter (copy for file)
____ Provide 401(k) withdrawal distribution forms with special tax notice
____ Request pension calculation, if applicable
____ Send pension paperwork to employee
____ Request pension withdrawal
____ Explain company policy on employment verification
(Co. only verifies dates of employment, position and with signed authorization, salary will be confirmed. Unemployment Office is the only agency that Company may provide reason for separation.)
- Benefits — Human Resources
____ Notify carriers of termination:
Medical
Dental
Life/disability
FSA
401(k)
Other
____ Review employee’s personnel and confidential files, and transfer files to inactive status
____ Update I-9 form and transfer to inactive status
- Other Actions
