EMPLOYEE EXIT CHECKLIST
This form must be completed on or before an employee's last day of employment.
Employee Name: Position: Supervisor: Facility: Termination date:
ITEMS ACCOMPLISHED: Termination of Employment form completed and given to employee Letter of resignation/termination sent to Human Resources Department Exit Interview Questionnaire given to employee ITEMS COLLECTED:
Check appropriate items collected. Indicate NA for those items not in employee's possession.
Orientation/Agency Manuals Agency papers/documents Identification card Keys to building, office, desk, file cabinets, etc. Cell phone, casing, charger Petty cash/flexible monies/telephone monies Desk supplies Computer supplies (manuals, workbooks, disks, notebooks etc.)
__________________________________________ Supervisor’s Signature c: HR Personnel File
_________________________ Date