Employee Termination Form
Submission ID-TRM
Employee Name
*
First Name
Last Name
Location
*
Please Select
JBR
ADC
PGD
MDK
STL
JAN
LDC
IP Warehouse
Remote
Manager Name
Manager - Requestor
Please Select
Anil Patil
Bernie Hogue
Cecilia Smith
Chris Wagley
Craig Cheatham
Craig Willingham
Dawana Craig
Eddie Hembrey
Ivan Tritch
Jake Hardage
Jim Hartl
Kevin Hart
Kevin Lowe
Lael Breckenridge
Mariah McMasters
Myra Brewer
Nahush Kasture
Robert Jean
Solomon Soans
Sourangsu Sarkar
Tasher Xu
Tim Cimmerer
Tonja Gibson
Location - Calculated
Manager - Requestor
Please Select
David Johnson
Gary Dierks
Larry Jewell
Laura Bell
Matt Foley
Richard Daniels
Rich Pierce
Satya Garg
Steven Riek
Subbu Subramanian
Manager - Requestor
Please Select
Adam Holznecht
Amanda Gonzalez
Angie Forrest
Brian Niemi
Colin Pearcy
Fidel Cardenas
Jon Thiering
Mary Webster
Paul Schumacher
Randy Heisz
Rich Pierce
Rob Denig
Tim Stirmel
Manager Email
example@example.com
Last Day Worked
*
-
Month
-
Day
Year
Date
Type of Hire
Hourly
Salary
Job Title
*
Job Title
*
Please Select
Accounting Assistant
Accounting Manager
Automation Technician
CDL Driver
CNC Operator
Commercial Sales Manager
Design Manager
Director of Operations
ERP Functional Analyst
Extrusion Manager
Extrusion Material Handler
Extrusion Operator
Extrusion Technician
Grinder
HR Coordinator
HR Manager
HR Specialist
IT Technician
Logistics Manager
Machine Operator
Maintenance Administrative Assistant
Maintenance Janitor
Maintenance Manager
Maintenance Supervisor
Maintenance Technician
Manufacturing Engineer
Material Handler-AP
Material Handler-PDC
Process Engineer
Process Manager
Process Technician
Process Technician Lead
Product Auditor
Production Lead
Production Manager
Quality Assurance and Safety Manager
Regional Sales Manager
Scheduler
Senior Sales Support Rep
Set Up Technician
Shift Supervisor
Tool Crib Attendant
Tool Design Engineer
Tool Design Intern
Tool Designer
Tool Room Attendant
Tool Room Supervisor
Training Supervisor
VP of Sales
Warehouse Coordinator
Warehouse Supervisor
Job Title - Output
Company Issued Items to be Collected
Uniform Shirts
Uniform Pants
Tool Box review
M3 Key
LOTO Locks
HASP
Equipment Keys
Automation Keys
Storage Keys
Power Tools
Selected by Default
Additional Comments for HR
IT Requirements
All hardware must be returned to the IT department before being reassigned to any replacement hires.
IT Hardware Pickup
Computer
Mobile Phone
None
Manager Access to Mailbox
Yes
No
Manager Access to Files
Yes
No
Additional Comments for IT
Date
-
Month
-
Day
Year
Date
Human Resources Requirements
Actual Termination Date
-
Month
-
Day
Year
Date
Removed Door Access
Yes
No
Approvers Email
example@Anchorpac.com
Submit
Should be Empty: