Exit Checklist and Notice

Exiting Employee Checklist and Notice

First name*
Last name*
Personal Email Address*
Primary Work Site*
Position*
Effective Date*

MM slash DD slash YYYY
Has your address or phone number changed?*
If any changes, what are they?
Keys to Building/Swipe Card Returned
Resignation Statement
Credit Cards
What should be done with PTO?
ID Badge Returned
Equipment Returned (Laptop, Wireless Mouse, Cell Phone, Internet Card, Etc.)
Laptop Tag # (Green Tag on Laptop)
Logins (What did you have logins for? Email, Champs, NextGen)*
Handbook
Other Items Obtained
To be discussed:*
- The items have been discussed.
– Extended medical coverage insurance plan (for COBRA requirements)
– Outstanding Bills to PC
– Unemployment Insurance Claim (provide instruction
sheet)
– PTO payout if applicable
– FHC Debt
Other notes to be shared
Offboarding tasks have been assigned in Bamboo?
Interviewer*
Interviewer Email*