SEPARATION FORM INSTRUCTIONS

Complete all fields and send via email to your HR Team.

EMPLOYEE INFORMATION

Employee Name Employee Number

SEPARATION INFORMATION

Effective Date _ _ / _ _ / _ _ _ _ DD/MM/YYYY

The last date the employee will be paid

Notification Date _ _ / _ _ / _ _ _ _ DD/MM/YYYY

This is the date when the employee notified ELC of the separation

Last Day Worked _ _ / _ _ / _ _ _ _ DD/MM/YYYY

The last day we consider the individual to be an employee of the organization

SEPARATION REASON

Separation Reason

APPROVALS

Manager Approval HR Contact Approval

Name Name

HR Connect ID HR Connect ID

Signature Signature

Date Date

Country