Exit Interview Form

{{company_name}}

{{company_address}}

Phone: {{phone}} | Email: {{email}} | Web: {{website}}

Exit Interview Form

Complete all sections of this exit interview form in BLOCK CAPITALS. Incomplete forms cannot be processed.

Employee Details

Request / Information

Declaration

I confirm that the information provided in this form is true, complete, and accurate to the best of my knowledge. I understand that providing false information may result in disciplinary action.

Manager Review

HR Action

Acknowledgement & Signatures

By signing below, both parties confirm they have read, understood, and agreed to the terms of this document.

Notice of Resignation

I, {{employee_name}} ({{employee_id}}), hereby formally tender my resignation from the position of {{job_title}} in the {{department}} of {{company_name}}, with effect from {{effective_date}}, in accordance with the notice period set out in my employment contract.

Reason & Acknowledgement

I am grateful for the opportunities, growth, and relationships built during my time with {{company_name}}. I am committed to ensuring a smooth and professional handover of my responsibilities during the notice period.

Handover Plan

Continuing Obligations

1. Confidentiality obligations under my employment contract continue post-separation.
2. Any non-solicitation and non-compete clauses remain enforceable as agreed.
3. All Company property, data, and intellectual property remain the property of the Company.

Final Settlement Request

Document Control