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Termination Log Summary


Name of Employee: ______________________

Department: ______________________

Date of Termination: ______________________

Final Date of Employment: ______________________

Last Rate of Pay: ______________________

Last Grade: ______________________

Reason For Termination: ______________________

Additional Comments:

 
PREPARED BY: APPROVED BY:
______________________
Name and Title
______________________
Name and Title Of Supervisor:
______________________
Signature:
______________________
Signature Of Supervisor:
______________________
Date:
______________________
Date:
Copyright 1998 Steven M. Sack

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