| Employee Name | |
|---|---|
| Employee ID | |
| Job Title | |
| Department | |
| Manager | |
| Termination Date | |
| Last Working Day |
| Item | Returned? | Comments |
|---|---|---|
| Laptop | ||
| ID Badge | ||
| Mobile Phone | ||
| Keys | ||
| Other |
| System | Revoked? | Comments |
|---|---|---|
| Network Access | ||
| Software Licenses | ||
| Other |
| Task | Completed? | Comments |
|---|---|---|
| Final Payroll Processed | ||
| Benefit Information Provided | ||
| Exit Interview Scheduled | ||
| Other |