Termination Report

First Name: *

Last Name: *

Job Title: *

Department: *

Start Date: *

End Date: *

Type of Termination: *

If Other, please describe (Voluntary Termination Reason):

If "Violation of Policy", please describe ( Involuntary Termination Reason):

If "Other", please describe (Involuntary Termination Reason):

Would you rehire this individual? *

Please write a brief narrative: *

Please also attach any evidence that you have:

Time Logs, Resignation Letters, Warnings

Date *

Manager's Name: *

Signature *