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Name of employee who quit:
*
Last day of employment
*
Person filling out this form
*
Company the employee worked for:
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Built
Uneeke
MCON
Supply Options
How long has the employee worked for the company (approximately)?
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Is the foreman or crew leader aware that this employee quit?
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Yes
No
Tools returned?
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Yes
No
Reason the employee quit?
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Attendance
Another Job
Disability
Dissatisfaction with Compensation
Dissatisfaction with Co-Worker
Dissatisfaction with Supervisor
Enlisted in Armed Forces
Family Reasons
Health Reasons
Insubordination
Involuntary Other
Involuntary Retirement
Job Abandonment
Job Position Eliminated or Changed
Leave of Absence and Did Not Return to Work
Marriage
Personal Reasons
Refusal to Follow Instruction
Refused Suitable Work
Relocation
Return to School
Unsatisfactory Performance
Violation of Rules
Voluntary Other
Voluntary Retirement
Without Notice or Reason
Working Conditions
Work Schedule
Are there any final deductions that need to be considered on the employee's final check?
*
Please explain in detail why the employee quit:
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Do we need to hire someone to replace the employee?
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Yes
No
Unsure
Is this employee approved for future re-hire?
*
Yes
No
Unsure
Additional Comments, if needed
*
Screenshots, Documents, etc., if needed
Click or drag a file to this area to upload.
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