Below is a termination background sheet, as well as a checklist to use when an employee is terminated.
TERMINATION BACKGROUND SHEET
Employee Name: ______________________
Employee Number: ______________________
Job Title: ______________________
1. History of previous discipline issued in past two years:
|Type of Discipline||Reason Issued||Date of Issue|
2. If no previous discipline has been issued, please state specifically why termination is recommended at this time:
3. Has your management provided information concerning what type of discipline has been issued to other employees involved in similar matters? If yes, is the recommended termination consistent with discipline issued to others? If no, when will the information be provided?
4. Are there any other facts and circumstances which should be considered in reviewing this decision?
Signature of individual making recommendation:
Not Approved (state reasons why and alternative recommendation):
The following items were received from employee at the time of his or her termination:
|ID badge||Keys||Security card||Credit card||Phone card||Safety equipment|
|In addition, the employee returned the following equipment which was provided by the Company for use in employment:|
|The following items were given to the employee at the time of his or her termination:|
|Final paycheck||COBRA notice||Exit questionnaire||Other:|
Human Resource Representative Signature
SOURCE: Maureen F. Moore, Employment Forms and Policies, Fourth Edition, LexisNexis. For more information, see http://www.lexisnexis.com/humanresources
©2003 Matthew Bender & Co., Inc., a member of the LexisNexis Group
The information contained in this article is intended to provide useful information on the topic covered, but should not be construed as legal advice or a legal opinion. Also remember that state laws may differ from the federal law.