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EMPLOYEE SEPARATION FORM <br /> Please notify HR immediately of employee separations so verification <br /> of compliance with Labor Law Regulations can be met <br /> �.ifn,�lel'Mli9q¢ <br /> Brey�don Sherman <br /> Employee Name: ' <br /> Resignation Termination <br /> If an employee voluntarily quits or resigns,they are to receive If an employee is terminated,a final paycheck,by law, <br /> their wages due&payable upon the next regular pay period must be in the employee's hand at the time of separation <br /> Check the appropriate box es below: Check the appropriate box es below: <br /> [:]Voluntary Resignation FlLay off- Permanent <br /> E]Medical Leave of Absence ayoff—Seasonal Employment <br /> F-lRetired Layoff—Project Closed <br /> []Returned to School Excessive Absenteeism <br /> [7]Dissatisfied with Working Conditions Excessive Tardiness <br /> E]Abandoned Job/No Call/Show Days Ejfheft of Company Property <br /> E]Accepted Another Job Offer ork Performance <br /> [7]Death nable to Get Along with Co-workers <br /> estructure/Position Change Under Influence of Alcohol or Drugs <br /> []Relocated away from Project Location Restructure/Position Eliminated <br /> E]Voluntary Personal Leave of Absence Falsifying Time Sheet <br /> o Reason Given Text Insubordination (Documentation Required) <br /> E]Walked Off Job Destruction of Company Property <br /> End of Season/Temp Employment Sexual Misconduct <br /> ailure to Return from Leave of Absence Repeated Violations of ESCO Policies <br /> F-10ther: E]Failed Drug Screen <br /> QI'ransferred to Another Location <br /> [:]A Letter of resignation is attached Other: <br /> DEmployee Declined providing a letter Is employee eligible for rehire? Yes <br /> No <br /> Date of Termination: i z-17-zo Last Day Worked: 1 zT5-zo <br /> Comments: <br /> Final P Employee has received final pay ourly: Reg 24 hrs OT hrs <br /> Salary or Commission:$ nVacation or Severance: hrs $ <br /> DAny Deductions/Reimbursements (Specify): $ <br /> Employee needs to return Company Property (Specify): _ <br /> Nate Johnson iz-i�-zo <br /> Authorized Signature: t Date: <br />