Free Sample Separations Of Employment Policy
download free sample human resources policies and job descriptions

Sample Separations Of Employment Policy

Donate & Download Entire Site

Separations of Employment



Employees must resign in writing to their appropriate supervisor and provide one month’s notice.  A resignation is a break in service and employees who resign do not have the right to appeal.

Job Abandonment

Employees absent for three consecutive workdays without authorization are deemed to have abandoned their positions and can be terminated.  Employees terminated due to abandonment will be notified of the termination in writing by certified mail.

Termination During Probation Period

Employees who voluntarily terminate or involuntarily terminate during the probation period do not have the right of appeal.


Employees can be dismissed only for cause and normally only after at least one written warning regarding the same issue and establishing a reasonable time limit for improvement.  All dismissals must be reviewed by Human Resources before any notice is served.

Employees will normally be given  weeks' written notice prior to dismissal.  In unusual cases, notice will not be given and dismissal is immediate.  In these situations, dismissed employees will receive  weeks’ pay in lieu of notice.  Employees dismissed during probation do not receive pay in lieu of notice.

Resignation Or Termination Pay

Accumulated annual leave and/or earned compensatory time will be paid out through payroll upon resignation or termination.  The retirement plan and other group benefits will continue until the last day paid.

Pay Upon Death

ABC will pay the salary of a deceased employee for an additional month after the month in which death occurs.  Salary continuation will therefore continue for one – two months after the death of an employee.

The appropriate supervisor should submit an Employment and Staff Changes Form to Human Resources.  This form should include: the reason for separation, accumulated annual leave balances, compensatory time balance and accumulated sick leave information where necessary.


Resignations and terminations are documented on the Employment and Staff Changes Form.

·         The department will notify HR of the employee's pending separation.

·         HR will notify Finance and request notification from Finance of outstanding obligations.

·         HR will request an Employee Separation Statement from the department.

·         Finance will notify HR and the department of any outstanding obligations.

·         The department will notify the employee of any outstanding obligations.

·         HR will have Payroll hold the employee's final pay the earlier of  days after separation or until all obligations are satisfied.


The department notifies Human Resources of an employee's separation using the following form:

NOTIFICATION DIRECTIONS: Please complete and forward to Human Resources once resignation is received.


Please begin the separation process for the employee below:

Employee Name:           ________________________________

Social Security Number:            ________________________________

Department:                  ________________________________

Last Day Worked:         ________________________________

Last Day Paid:              ________________________________

Contact Name:              ________________________________

Contact Phone Number: ________________________________


Human Resources notifies Finance of the employee's termination.  Finance will notify Human Resources of any outstanding obligations requiring action.

The following individual is terminating as of the effective date shown below.  Please review your records and indicate whether or not this individual has any outstanding obligations in equipment, funds or materials within  days of receipt of this notice.

Employee Name:           ________________________________

Social Security Number:            ________________________________

Department:                  ________________________________

Obligation                     ________________________________

Obligation                     ________________________________

Obligation                     ________________________________

Obligation                     ________________________________

Obligation                     ________________________________

Please notify this office when the obligation(s) has/have been satisfied.


1.             ______________________________________________________________

2.             ______________________________________________________________

3.             ______________________________________________________________

4.             ______________________________________________________________


The home department forwards the following Employee Separation Statement to Human Resources prior to employee's last day of work.

The supervisor will complete this form with the employee prior to the employee’s last day of work and indicate that the employee has/has not satisfied all the separation requirements.

The determination for each item listed below is noted in the "Comments" section as "returned", "lost", "not applicable", etc.


1. Identification Card                 _____________________

2. Keys/Security Cards              _____________________

3. Manuals/Handbooks              _____________________

4. Vehicle Credit Cards              _____________________ 

5. Equipment/Tools/Uniforms     ____________________

Please forward this completed form to HR.  Return ID Card and Manual/Handbook to HR within  working days from employee's termination.  HR will take any necessary action regarding items requiring holding of Payroll check.

Donate & Download Entire Site