Fillable Form Employee Separation Form

What is an Employee Separation form?

An employee separation form is a document used by companies when an employee got separated from the company due to resignation, retirement, medical conditions, personal reasons, and any other reasons that affected his or her employment. This document serves as a final record and validates that an employee is no longer connected to the company. This can also be used for assessing the final pay or back pay of the employee.

Tips in filling out an Employee Separation form

• The words used in this letter must be professional and concise. Avoid using any casual or informal language even if you have a familiar relationship with the employee. Otherwise, it may affect the credibility of the company.
• Mention specific reasons for separation for transparency purposes. Only include accurate information and do not include inaccurate or exaggerated information.
• Make sure that the employee receives all stated financial benefits in this form. The payment method and the amount should be accurate.

For your convenience, an Employee Separation form template is available on PDFRun. You can use the template and fill it out with the following information:

Employee

Enter the full name of the employee.

Date

Enter the date when you are filling out this form.

Position

Enter the position of the employee.

Start Date

Enter the date the employee started.

Email

Enter the email address of the employee for contact purposes.

Phone

Enter the phone number of the employee for contact purposes.

Address

Enter the address of the employee.

Voluntarily left due to

If the employee voluntarily left, mark the box that selects the appropriate reason

Select if:

• New position.
• Relocation or transfer.
• Medical Condition.
• School.
• Conflict with superior, co-worker, schedule, or pay. If marked, indicate the conflict.
• Retirement.
• Personal.
• Other. If marked, indicate the reason.

Involuntarily left due to

If the employee involuntarily left, mark the box that selects the appropriate reason

Select if:

• Tardiness.
• Absenteeism.
• Insubordination.
• Unsatisfactory Work.
• Job eliminated or changed.
• Lack of work.
• Disability.
• Other. If marked, indicate the reason.

Explanation

Enter the explanation of the employee regarding the separation.

Employee Statement

Enter the statement of the employee regarding the separation.

Separation is

Mark the box to determine the type of separation. You may select:

• Temporary
• Permanent

Work will resume on

If separation is temporary, enter the date when the work resume for the employee.

Employee is eligible for rehire?

Mark Yes if the employee is eligible for rehire; otherwise, mark No.

If no, why not?

If an employee is not eligible for rehire, enter the reason for his/her ineligibility.

Employee Received

Mark the appropriate box to determine what the employee received. You may select if:

• Severance Pay
• Wages in Lieu of Notice
• Bonus
• Profit-Sharing

Payment Type

Enter the type of payment made to the employee.

Payment Amount

Enter the amount of payment to the employee.

Period

Enter the period of payment to the employee.

Employer

Enter the full name of the employer.

Account No.

Enter the account number of the employer.

Position

Enter the position of the employer.

Start Date

Enter the date the employer or the company started.

Email

Enter the email address of the employer.

Phone

Enter the phone number of the employer.

Address

Enter the address of the employer.

Employee Signature

Enter the signature of the employee.

Date

Enter the date signed by the employee.

Employer Signature

Enter the signature of the employer.

Date

Enter the date signed by the employer.

Reminders on separating from your job:

Do it properly

As a professional, it is important to follow all necessary steps when leaving your job. Take time to inform your employer regarding the decisions you have that concern your employment. You should also write a formal resignation letter or ask for a meeting with your boss. Upon giving a separation notice, you should specify your last day of work or the effective date of your resignation. Make sure to finish all the tasks assigned to you before leaving the company.

Leave on good terms

As you leave your job, leave a remarkable impression in the company. You may want to give them credit for what they have contributed to your career. You can also mention how they created an impact on your growth as a professional. When you resign, it is essential to aim to make a lasting positive impression. A few mistakes can affect how you are perceived for the years to come.

Reasons why an employee resigns

Here are common reasons why employees choose to resign from their company:

Underpaid

Salary is a contributing factor to why an employee resigns. Sometimes, If you work so much and get so little in return, it pushes you to look for another job that can provide the income that you think you deserve. Offering competitive salaries motivates an employee to stay.

Unchallenged

Employees tend to get bored when doing the same routine for a long time. Even if the job pays well, some people desire to try something new that would push them to develop their existing skills and gain new skills. An effective way to retain employees is to provide them with more challenging tasks and stretch goals. It is one way of telling the employees that the company is entrusting them to continue developing.

Undervalued

When a company fails to recognize the employees' achievements, they may seek value elsewhere, such as a new job. Showing appreciation to employees does not necessarily require giving awards or financial incentives. Sometimes, it can be as simple as providing positive feedback or verbal recognition.

Failed relationship among co-workers

Employees may be forced to leave the job if they experience mistreatment from their co-workers and bosses. The productivity of an employee may be affected if they deal in an unpleasant workplace. As a company, make sure that the employees have time to establish a relationship with one another.

Work and life balance

Employees seek out companies that allow them to be more flexible around their work schedules. Employees usually prioritize their well-being, especially in isolated situations.