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Employee termination form template

The internal record of how employment ended: the type and reason, final pay and benefits, what comes back and when access stops.

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Preview · answers aren’t saved

Employee’s name (required)

Job title (required)

Department (required)

Employment type (required)

The separation

Last day worked (required)

Separation date, if different

For example when paid leave runs past the last day worked.

Type of separation (required)

Explain what happened

Facts and dates. Required for a dismissal.

Was notice given?

Resignation letter or supporting documents

For a dismissal, the disciplinary action forms that led to it.

Click or drop a file here

PDF, Word, images · up to 10 MB

Eligible for rehire? (required)

Final pay and benefits

For payroll.

Hours or leave to pay out

Unused leave, overtime or anything else owed.

Final paycheck date

When the last pay reaches the employee.

Benefits to end

Choose as many as you like

Equipment and access

Items to return

Choose as many as you like

Date to switch off system access

Sign-off

Completed by (name and role) (required)

Manager’s signature (required)

Draw your signature, or choose Type instead to type your name.

26 questions · about 5 min · logic · file upload · signature

  • No sign-up to start
  • Unlimited responses on Free

Print it as a PDF Word version

Change the questions in Word, then print.

What you get back

Every response lands in your results the moment it is sent. Turn on email notifications and each one arrives like this, and the same answers become a row in your spreadsheet.

From PulseFormCreator

Subject New response to Employee separation record

Employee’s name
Priya Raman
Job title
Accounts assistant
Department
Finance
Employment type
Part-time
Last day worked
28 Aug 2026
Type of separation
Resignation

and 12 more answers

A sample email with made-up answers.
submitted_atEmployee’s nameJob titleDepartmentEmployment typeLast day worked
23 Sep 2026 09:41Priya RamanAccounts assistantFinancePart-time28 Aug 2026

Export to CSV or Excel, or send responses to Google Sheets, Notion, Airtable, Slack or a webhook. All free.

What happens after someone submits

A departure reaches payroll, benefits and IT on the same day, from one record.

  1. Submitted

  2. A separation is recorded

    Payroll and IT get the same email, with a PDF of the record attached.

  3. It is a dismissal or layoff

    HR gets its own email only for those two types, to check the notice and written-reasons rules.

  4. At the same time

    Responses go to Google Sheets, so every departure sits in one dated list.

Set this up when you use the template

What this form asks, and why

The last column shows how often real employee termination forms ask for it.

Question Why it is there Real forms
Employee’s name Required Whose record this is, asked on 10 of 10 forms. 10 of 10 forms
Job title Required Payroll and the replacement request both need it. 5 of 10 forms
Department Required Routes the record. A link can fill it in. 6 of 10 forms
Employment type Required Changes what is owed and which benefits end. 4 of 10 forms
Last day worked Required Final pay runs to here. 6 of 10 forms
Separation date, if different Optional, for paid leave that runs past the last day worked. 7 of 10 forms
Type of separation Required Decides unemployment claims and rehire, and picks the reason list. 5 of 10 forms
Main reason given Required Only when “Type of separation” is “Resignation” or “Retirement” A list, as on 7 of 10 forms, so departures can be counted. 7 of 10 forms
Main reason for the dismissal Required Only when “Type of separation” is “Dismissal” Employment reasons only. Medical detail stays off the form. 7 of 10 forms
Reason for the layoff Required Only when “Type of separation” is “Layoff or end of contract” Tells a later reference check it was not about performance. 7 of 10 forms
Explain what happened Required for a dismissal: the facts and dates behind it. 3 of 10 forms
Were there earlier written warnings? Required Only when “Type of separation” is “Dismissal” Shown for a dismissal: links to the warnings behind it. 1 of 10 forms
Was notice given? Affects final pay and rehire. 2 of 10 forms
Resignation letter or supporting documents The resignation letter or the warnings; 3 of 10 forms ask for one. 3 of 10 forms
Eligible for rehire? Required Answers the reference call years later. Only 3 of 10 forms ask. 3 of 10 forms
Why not? Required Only when “Eligible for rehire?” is “No” Shown after No. 3 of 10 forms
Hours or leave to pay out Payroll’s main input: unused leave, overtime and anything else owed. 4 of 10 forms
Final paycheck date Our addition: some states set a deadline for the last paycheck. Our own recommendation
Benefits to end Starts the end of cover, and COBRA notices in the US. 4 of 10 forms
Date cover ends Only when “Benefits to end” is answered and “Benefits to end” does not include “None” Shown once a benefit is checked. 4 of 10 forms
Items to return One checklist instead of a line per item. 1 of 10 forms
Date to switch off system access When accounts close. 3 of 10 forms
Employee’s personal email For the final pay stub and tax forms once the work account closes. 3 of 10 forms
Forward their work email to Where customers’ emails go next. 3 of 10 forms
Completed by (name and role) Required Who is accountable for the record. 3 of 10 forms
Manager’s signature Required Signed on 6 of 10 forms. 6 of 10 forms

What we left out

  • Social Security number. 4 of 10 forms ask. Payroll already holds it.
  • The employee’s signature. On 6 of 10 forms, but a dismissed employee may not sign, so only the PDF has a line. The resignation preset asks for one.
  • Reasons like “unhappy with pay”. They belong in an exit survey in the leaver’s own words, not the manager’s.

What 10 real employee termination forms ask

How many include each field, from forms organizations use today. Part of the Form Field Index.

  1. The employee's name 10 of 10
  2. Reason for leaving 7 of 10
  3. Date beside a signature 7 of 10
  4. Termination or separation effective date 7 of 10
  5. Department, project or organization code 6 of 10
  6. Employee's signature line 6 of 10
  7. Last day actually worked 6 of 10
  8. Manager’s signature 6 of 10
Read September 2026 · US 10 · Sources
  1. National PEO · PEO (HR outsourcing firm), US
  2. Jackson County, Illinois · county government, US
  3. FRM (Florida Resource Management) · PEO (HR outsourcing firm), US
  4. City of Little Rock, Arkansas · city government, US
  5. Expert Computer Solutions (ECS) · IT services company (client form), US
  6. StaffScapes · PEO (HR outsourcing firm), US
  7. Seton Hall University · university, US
  8. Lee University · university, US
  9. Oxnard Union High School District · school district, US
  10. CSUSM Corporation (Cal State San Marcos auxiliary) · university auxiliary, US

How the form changes as people answer

Most people see a shorter form. These questions and screens only appear when an answer calls for them.

  1. When “Type of separation” is “Resignation” or “Retirement”

    shows “Main reason given”

  2. When “Type of separation” is “Dismissal”

    shows “Main reason for the dismissal” and “Were there earlier written warnings?”

  3. When “Type of separation” is “Layoff or end of contract”

    shows “Reason for the layoff”

  4. When “Eligible for rehire?” is “No”

    shows “Why not?”

  5. When “Benefits to end” is answered and “Benefits to end” does not include “None”

    shows “Date cover ends”

  6. When “Type of separation” is “Dismissal” or “Layoff or end of contract”

    shows the “Separation recorded” ending

Make it yours

  1. Keep it to managers

    Turn on Password protection in Settings → Access and limits, and share the password with people who manage staff.

  2. Match it to the HR record

    Add ?dept=Finance&employee_id=E2231 to the link. The ID is saved as a hidden field.

  3. Use your own reason lists

    Edit “Main reason given” and the dismissal reasons to the categories your reports count.

Good practice and the law

This is general information, not legal advice. Rules differ by country and state, so check anything important where you operate.

Questions about this template

What goes in the termination letter?

This record stays internal. Copy four of its answers into the letter: last day worked, final paycheck date, the date cover ends, and the items to return.

Do I have to give the employee a separation notice?

In some US states, yes: the five listed above. Both thank-you screens remind you to check.

Can an employee use it to resign?

Pick “Resignation” above the preview: the employee gives notice, a reason if they want to, a personal email, and signs.

Can I use it as an offboarding checklist?

Pick “Offboarding clearance”: it drops the reasons and rehire questions and adds sign-offs for IT, finance, HR and facilities.

Which form do you need?

Not quite the job? One of these may fit, or browse all HR and employee forms.

Start with the employee termination form template

Open it in the editor and fill it in on the day someone leaves.

Use this template

By , founder of PulseFormCreator. Updated 23 Sep 2026.