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EMPLOYEE NAME:             


The following items should be checked off prior to an employees final date of employment. Not all items will apply to all employees or all circumstances. Place the completed form in the employees personnel file.


Termination Notice

Meet with the employee in a private, neutral location, such as a conference room or closed office, to minimize their embarrassment or discomfort.

Inform the employee why they are being fired or laid off.

Explain when the termination will be effective. If today is the employee's last day, outline the procedures for exiting the premises. If the employee will remain at the company for a set period of time, tell them what is expected of them during the transition period.

Give the employee a termination letter that documents their last day, outlines the reasons they are no longer working for the company, and provides information about severance benefits and other termination details.

Insurance and Benefits

Disclose the date that the employee's medical, dental, vision, life and long-term disability insurance coverage will end.

Explain COBRA, the federal act that provides employees who experience a "qualifying event" (such as a termination) with the right to continue their current group insurance coverage.

Give the employee a written statement that explains when their benefits will terminate, outlines COBRA law, lists monthly premiums and provides enrollment information.

Provide a closing statement with information about the company's stock option, profit sharing and/or employee stock-ownership program. The statement should show how many shares the employee has vested, the price per share and the deadline for exercising the shares.

Give the employee documentation about their 401(k) or retirement savings plan. Make sure it spells out when company contributions to the plan will end, explains rollover options and contains contact information for the plan administrator.

Settlement and Arbitration Agreements

Ask the employee to sign an arbitration agreement that states that all controversies and employment-related disputes will be resolved through arbitration and not litigation.

If you're concerned about possible litigation, ask the employee to sign a settlement agreement. By signing such a document, the employee releases any claims against the company in exchange for payment. (Consult your attorney or an employment-law specialist to determine if a settlement agreement is necessary.)

Give the employee photocopies of the signed agreements or ask them to sign duplicate copies.

Paycheck, PTO Payout and Severance

If today is the employee's last day, give them their final paycheck along with a check for accrued vacation or paid time off (PTO).

Discuss any severance the employee will receive and explain how it will be paid out.

Severance Pay and General Release agreement offered.

Give the employee a letter that explains the terms of the severance package.

Company-Owned Equipment

Company software returned

Company cellular phone returned

Company pager returned

Company credit card returned

Company phone card returned

Employee identification card returned

Building/office keys and access cards

Parking permit or garage key

Bank depository keys


Company vehicles returned

Have the employee sign a document that states that they have returned all company property

Expense and Transition Reports

Instruct the employee to complete a final expense report and submit it on or before their last day

If the employee will remain at the company for a set period of time, ask them to provide a transition report that details the projects they're working on.

Exit Interview and Employee Assistance

Conduct an exit interview (if appropriate) to learn from the employee's experience at the company

Ask the employee if they have any questions or final comments

Discuss any outplacement services or employee assistance the company will offer

Exit interview given

Exit interview prepared

Office Operations

Discontinue the employee's email account and network access

Change sensitive access codes, including bank PINs and security codes

Cancel phone and voicemail accounts

Change locks

Cancel appropriate magazine, newsletter and newspaper subscriptions

Staff Notification

Notify employees, clients and vendors about the termination and tell them who will handle the terminated employee's responsibilities

Answer questions and concerns your staff has about the termination without disclosing any sensitive information or infringing on the terminated person's privacy

Human Resources, Payroll and Security Departments have been notified of employees departure

Final expense report received, reviewed and approved, expense check prepared

Final check prepared (includes all vacation pay, sick pay, accrued wages, bonuses, etc.)

Notice of unemployment rights provided

Termination Certification signed

Profit sharing election forms provided.

Company documents and files inventoried.

Desk and working premises inventoried.

Company has no further liability with the terminated employee.

Supervisors Signature:            Date:         

Department:              Date:        

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