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Employee Termination Notice
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9999
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MM slash DD slash YYYY
Date of Termination
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MM slash DD slash YYYY
Last Day Worked
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MM slash DD slash YYYY
Voluntary
To accept other work
Medical / Maternity leave
Relocating to another area
Personal / Family responsibilities
To attend school
Military service
Failure to return from leave of absence
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Job dissatisfaction
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Voluntary
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Repeated insubordination
Repeated tardiness / absenteeism
Falsified information on application
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Dishonesty / Theft
Failed to maintain union status
Substandard performance
Destruction of company property
Probation period (within 90 day)
Violation of Drug Free Workplace Program
Layoff
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Job position eliminated
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Employee Signature
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Date
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Supervisor Signature
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Date
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Human Resources Signature
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Date
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