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Employee Separation Form - Fill & Save PDF

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Record the essential details with a ComplyRight™ printable employee separation report

When an employee quits, is laid off or retires it's important to document all the facts. Make the Printable Employee Separation Form part of your separation process to get all the details in writing - and to ensure your company is protected.

Fill & Save eForm – Download the PDF and then type info directly into fields.
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  • Captures key information including separation reasons, final pay, COBRA rights and retirement savings distribution options
  • Printable format gives you access to your separation report minutes after checkout
  • IncludesFREE tip sheet
  • Upon completion of your order, you can access your printable product from the Manage My Downloads section
    in your account
  • Please note that printable forms are not returnable

Product Specifications:

  • Adobe Acrobat 5.0 or later is required for Fill & Save eForms

Record the essential details with a ComplyRight™ printable employee separation report

Employee Separation Form - Printable PDF

$19.99

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DO make sure the action conforms to written company policy.

Don’t say something you may regret later. Plan what you’re going to say beforehand.

DO be prepared to explain your reason(s) for termination such as consistent poor performance, a work rule/policy violation or a layoff. Get your documentation in order: termination notice, performance reviews, written warnings, salary information and all pertinent correspondence.

Don’t become too emotional and maintain your composure.

DO have a witness present who has been briefed on his/her role and who knows how to respond to comments. Be prepared to answer any questions your employee might have about the termination.

When an employee decides to end employment, it’s important to document his or her true reason for leaving because:

  • You may need the information to prepare a legal defense in case of a challenge.
  • You may need the information if you wish to contest unemployment compensation.
  • If more than one employee leaves, you may want to know the reason behind the pattern to determine what you can do to prevent more turnover


If you have 100 or more full-time employees or 100 or more employees (including part-time employees) who work a total of 4,000 hours each week, you may be covered by the WARN Act (Worker Adjustment and Retraining Notification Act), which was designed to give employees notice of layoffs. Covered employers are required to provide 60 days’ notice of qualifying plant closings and/or mass layoffs to employees and the local government.

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