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Hire/Fire/Retire/Transpire Desire Form

Company Name -Zappos.com, Inc. -Zappos Fulfillment Centers - Zappos CLT -Zappos Insights -Zappos Retail -Zappos IP -Zappos Development

-Zappos Merchandising
Legal Name: SS# (HR Only): Shift: Name

- 6pm.com
Payroll ID:

-Zappos Gift Cards


Code Number IBOB

Cost Center #:

cost_center

Cost Center Name: dept_name

Process (Pack/Ship, Putaway etc.):

Separation Employment Separation


Date of Separation: Last Day Worked:

Job Change
Date of Notice: Last Day Paid Through: Dissatisfied with Management Military Duty

Personal Change
2 Weeks Notice Given: Pay in Lieu of Notice: Yes Yes No No Job

Reason for Termination


Dissatisfied with Pay Abandonment Voluntary: Relocation/Retirement Dissatisfied with Position Deceased Dissatisfied with Schedule Pursue Education Job Opportunity Personal/Family Reasons

Resignation in lieu of termination

Other (contact HR before selecting this reason then list explanation): _________________________________________________________________________________________ Attendance Involuntary: Performance - Job/Culture Policy Violation Reduction in Staff Other (contact HR before selecting this reason then list explanation): _________________________________________________________________________________________ Seasonal: Comments: Eligible for Rehire: Yes No If No, Give Reason: Seasonal Temp. (assignment completed)

Job Change
New Cost Center Name: New Job Title: Current Salary: New Process (Pack/Ship, Putaway etc.) New Type (Regular, Temp): Pay Period Effect Date: Change Reason (REQUIRED): Effective_Date 90 day increase $Old_rate/ Hour or Year New Cost Center #: New Supervisor: New Salary: New Shift: New Status (Full/Part): $New_rate/Hour or Year

Personal Change
Name Change: New Address: For information change, Employee Signature Required: Date: New Phone #:

Approvals
Grace Heppler, HR Generalist
Manager/Supervisor Signature

5/17/11
Date CEO or COO Signature Date

Signature Verification:_________ HR Approval: ____________ HR Input Initials: ___________ Payroll _____________________

Date Input: ____________

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