Termination Payroll Adjustment Form
Employee Information
Employee Name
Employee ID
Job Title
Department
Manager/Supervisor
Date of Termination
Final Payroll Details
Last Work Date
Total Final Hours Worked
Overtime Hours
Unused Leave (Hours)
Bonus/Other Earnings
Deductions
Comments / Notes
Approvals
Prepared By
Date
Manager/Supervisor Approval
Date
HR Approval
Date