Notice of Separation

Employee ID*

Employee Name*

First

Last

Employee Email*

Employee Phone*

The following HRMS data tool link can be used to locate an employee’s position information:
Here

Does the employee hold multiple positions at TCC?*

Yes
No

What type of position or positions does the employee hold?*

Full-Time
Adjunct
Wage
Student
Work-Study

Position Number*

List ALL of the position numbers the employee holds (including ones not being terminated).*

Terminate all positions at TCC?*

Yes
No

List ONLY the position number or numbers to be terminated.*

Last Workday in Position*

Date of Separation

Provide “Date of Separation” if date is different from last workday in position, and only when employee is leaving the college (separating from TCC completely).

The employee will remain employed at the college as:*

Full-time
Adjunct
Wage
Student
Work-Study
The employee will not remain employed at the college

Please select one the following codes for the Reason for Leaving:

1. Transfer – within TCC
2. Transfer - VCCS Community College
3. Transfer – State Agency
4. Completed limited appointment
5. Death
6. Inactive contract period
7. Leave layoff expired
8. No show on 1st day/ Reneged
9. Removed – Faculty
10. Removed - Inability to perform
11. Removed - Performance during probation
12. Removed - Standards of Conduct

13. Resign - Better Job
14. Resign – Dissatisfaction
15. Resign - During probation
16. Resign - Home responsibility
17. Resign - Ill health
18. Resign – Relocation
19. Resign – Military
20. Resign – School
21. Resign – Other
22. Separation – LTD
23. Retirement
24. Other
25. Layoff - Full Time only
26. Position Elimination

Computer Account Access for Terminated Positions*

Keep all computer account access
Remove access to all email, network, and system accounts
Remove access to all accounts, with the exception of email

Reason for keeping access:*

Separation Checklist

Supervisor Checklist for Employee Separation form will be completed and submitted to HR

Notified Employee to submit final time sheet in HRMS?*

Yes
Not Applicable - Position does not require daily reported hours

Submitting Supervisor Name*

First

Last

Submitting Supervisor Email*