Auxiliary Enterprises Employee Termination Form

							For Office Use Only:
_____ Aux Ent Fiscal               _____ Aux Ent MIS                    _____ Aux Ent Personnel


                                       UNIVERSITY OF HAWAII
                                      AUXILIARY ENTERPRISES
                                    EMPLOYEE TERMINATION FORM

Name: _______________________________                     Department: __________________________

Termination Date: _____________________ (Last Day Worked)

Reason:
_____ Another Job            _____ Concentrate on School    _____ Graduation
_____ Personal matters       _____ Other:____________________________________________________

Final paycheck (Check one):

_____ I will pick up my final paycheck(s).

_____ Please mail my final paycheck(s) to the address listed below.

Direct Deposit (Check one):

_____ I have completed and attached Form D-60 to cancel direct deposit upon termination.

_____ I will submit completed Form D-60 as soon as possible. I understand that if this form is not completed,
      there could be problems in processing my paycheck if I am rehired by the State of Hawaii.

ID Card (Check one):

_____ I have/will return my UH Faculty/Staff ID card on or before my last work day.

_____ I was not issued a UH Faculty/Staff ID card.

Name Tag (Bookstore Employees):

_____ I have/will return my Bookstore name tag on my last work day.

Security Access Card (Bookstore Managers):

_____ I have/will return my Security Access Card on my last work day.

W-2 Form (Please initial):

_____ I understand that my W-2 form will be mailed to the address listed below, unless the Personnel Office
      receives written notification of an address change.

                                           Address:      __________________________________________
                                    City, State, Zip:    __________________________________________
                                           Phone No:     __________________________________________

                                                         __________________________________________
                                                        Employee Signature                     Date
Termform (Rev. 08-10-2004)