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Separation Notice Form

The information entered into this form will be sent to notify appropriate ذكذكتسئµ University departments regarding employee separations. The following areas will receive this information via email: IT Service Desk, Facilities Management, Parking Office, Finance, Travel, Library Circulation, and Human Resources. Departmental administrators or their designees are still responsible for ensuring all items on the Exit Checklist have been addressed. This form is designed to assist in the process.

Please enter below the employee's information, effective separation date, and supervisory contact information, add the Captcha security phrase shown and click the Submit button. If the employee's last day physically on duty is prior to the effective separation date, please indicate this in the comments section.