SUPPORT STAFF by fjzhangm


This form must be completed when:  

A Regular (continuing or non-established) or Auxiliary Monthly employee terminates from the UofA A Regular (continuing or non-established) or Auxiliary Monthly employee transfers from your department to another department

Return completed form to Terms & Conditions, Human Resource Services, 2-60 University Terrace as soon as possible so that a final cheque can be processed. When an employee is resigning, please attach a copy of the employee’s letter of resignation. Contact Human Resource Services for help on completing this form at 492-4555. Employee Name: Person Identification Number: Department/Faculty: Forwarding Address & Postal Code: Date of Termination (last day paid): Indicate Reason for Termination (check one) Resignation Resignation Obtained another job within the UofA Return to School Obtained another job outside the UofA Personal Reasons Not Returning from Maternity Leave Layoff Relocation Terminated for Cause Retired Contract Ended Other (please provide explanation in comments section) Deceased Vacation Payout Reconciliation (must be completed prior to submission to HR) Carried over from previous year Taken Year-to-Date Earned Year-to-Date Vacation Payout Please include partial month accrual for mid-month terminations. Calculation: hours earned per month divided by work days in month multiplied by work days paid ie 8.75 / 20 * 3 (Sept 1-Sept 5/07) = 1.31 hours FOR HR USE ONLY Transfer Vacation 735 Absences Taken Please indicate absences taken but not reported up to and including date of termination as well as any absences keyed into PISCES since last pay confirm. Do not key any absences into system for a mid-month termination. (Report in blocks of time ie Type of absence Vacation from September 1 to September 5 = 35 Working Hours) Type of absence Type of absence Type of absence from from from to to to = = = Working Hours Working Hours Working Hours Payout 732 730 _______hrs x $_______hourly rate

* If additional absences must be reported, please attach a Leave Reporting Form. Banked Time Payout Banked Time Balance Banked Time Earned But Not Reported Comments: Banked Time Taken But Not Reported Banked Time Payout

Prepared by: Date Prepared By: (printed name) Phone

Authorization and Approvals Date Authorized By: (printed name) Authorized By: (signature) Date Internal Control Approval: (printed name) Internal Control Approval: (signature)
The personal information on this form is collected for the purpose of managing personnel under the Employment Standards Code, Section 14(4) and in accordance with the Alberta Freedom of Information and Protection of Privacy Act, Section 33c. Certain personal information will be made available to federal and provincial departments and agencies under appropriate legislative authority. For further information contact Human Resource Services, 2-60 University Terrace, University of Alberta, telephone number 492-4555.


Original: Terms & Conditions, Human Resource Services 2-60 University Terrace

One Copy: Department
February 20, 2008

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