Fillable Printable Employee Separation Form - New Jersey

Employee Separation Form - New Jersey

Organization Code (Formerly Department #)

Today's Date

Employee’s Name (Last, First)

CWID #

Job Title Position #

Department

Campus

Employee Type

Status

Last Day Worked

mm/dd/yy

The separation date is the last day of active work. Holidays, vacation and personal days cannot be used as part of or as the

separation date.

Separation Reason*

* Letter of Resignation and/or Relevant Documentation must be attached

Would you rehire?

For Admin/Staff Only:

*Final Timesheet must be submitted to receive eligible accrued time payout

Supervisor/Chair Signature

Department Head/Dean Signature

Note:

If a replacement is needed, please be advised that a PeopleAdmin posting request must be submitted and

approved. Please contact Human Resources for further assistance.

For Human Resources Use Only

Graduate Tax

Yes No

Employee Separation Form

(To be completed by the supervisor)

Graduate AssistantFaculty

Admin\Staff

Full-Time

Part-Time

_____________________________________

HR Signature

_____________________________________

Payroll Signature

Temporary

Yes