Termination Slip

Please complete the information below and attach the termination slip within 48 hours of termination.

Termination Date:

Employee:

Classification:

Last four of SSN:

Termination Reason: 1 End of Job2 Needs Skill Improvement3 Excessive Absenteeism4 Reduction in Work Force5 Excessive Tardiness6 Lack of Production7 Under Influence8 Resignation9 Other- (State reason in text field below)

Remarks:

Eligible for Re-Hire:

Company Name:

Name and Title of Authorized Company Representative:

Enter the text shown in the image above.