Worksheet_Termination of Employment

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{phone}}

Email: {{email}}

Website: {{website}}

Employee Information

Employee Name: {{employee_name}}

Employee ID: {{employee_id}}

Job Title: {{job_title}}

Department: {{department}}

Date of Employment: {{date_of_employment}}

Date of Termination: {{date_of_termination}}

Reason for Termination: {{reason_for_termination}}

Termination Checklist

All items must be completed and initialled by the responsible party.

1. Notification of Termination (HR/Manager):

- Formal written notice issued: {{written_notice_issued_date}} (Initial: {{initial_written_notice}})

- Verbal notification provided: {{verbal_notification_date}} (Initial: {{initial_verbal_notice}})

2. Final Pay and Benefits (HR/Payroll):

- Calculation of final salary: {{final_salary_amount}} (Initial: {{initial_final_salary}})

- Accrued leave payout: {{accrued_leave_payout_amount}} (Initial: {{initial_leave_payout}})

- Provident Fund/Pension Fund withdrawal forms provided: {{provident_fund_forms_date}} (Initial: {{initial_provident_fund}})

- Medical Aid termination processed: {{medical_aid_termination_date}} (Initial: {{initial_medical_aid}})

3. Company Property Return (Manager):

- Company laptop/computer: (Returned: {{laptop_returned_date}}/Not Returned: {{laptop_not_returned_reason}}) (Initial: {{initial_laptop}})

- Mobile phone: (Returned: {{mobile_returned_date}}/Not Returned: {{mobile_not_returned_reason}}) (Initial: {{initial_mobile}})

- Access cards/keys: (Returned: {{access_cards_returned_date}}/Not Returned: {{access_cards_not_returned_reason}}) (Initial: {{initial_access_cards}})

- Company vehicle: (Returned: {{vehicle_returned_date}}/Not Returned: {{vehicle_not_returned_reason}}) (Initial: {{initial_vehicle}})

- Other company property (list): {{other_property_list}} (Returned: {{other_property_returned_date}}/Not Returned: {{other_property_not_returned_reason}}) (Initial: {{initial_other_property}})

4. Access Revocation (IT/Admin):

- Email access disabled: {{email_access_disabled_date}} (Initial: {{initial_email_access}})

- System access revoked (e.g., CRM, internal drives): {{system_access_revoked_date}} (Initial: {{initial_system_access}})

- Physical building access revoked: {{physical_access_revoked_date}} (Initial: {{initial_physical_access}})

5. Exit Interview (HR):

- Exit interview scheduled: {{exit_interview_scheduled_date}} (Initial: {{initial_exit_interview_scheduled}})

- Exit interview conducted: {{exit_interview_conducted_date}} (Initial: {{initial_exit_interview_conducted}})

- Feedback documented: {{exit_feedback_documented_date}} (Initial: {{initial_exit_feedback}})

6. Reference Policy Acknowledgment (HR/Employee):

- Employee informed of company reference policy: {{reference_policy_informed_date}} (Initial: {{initial_reference_policy}})

Confidentiality and Non-Disclosure Agreement

I, {{employee_name}}, acknowledge my ongoing obligation to maintain the confidentiality of all company proprietary information and trade secrets, and to abide by any non-disclosure agreements previously signed. I understand that any breach of this obligation may result in legal action.

Employee Signature: _________________________ Date: {{employee_signature_date}}

Acknowledgment of Receipt

I, {{employee_name}}, confirm that I have received all my final remuneration and applicable benefits, and have returned all company property as per the checklist above. I understand the terms of my termination and have had the opportunity to ask questions.

Employee Signature: _________________________ Date: {{acknowledgment_date}}

Witness or HR Representative

This termination worksheet was completed in my presence and appears to be accurate and complete.

Name: {{witness_name}}

Title: {{witness_title}}

Signature: _________________________ Date: {{witness_signature_date}}

Signature Block

_________________________ _________________________

Employer Representative Name Date

{{employer_representative_title}}