PRIVATE AND CONFIDENTIAL

Leaver Advice

Monthly paid employee weekly paid employee

Unit name Employee’s surname

Unit number Initial
Employee number Date of leaving

Reason for Leaving

01. Resignation – Leaving Industry

02. Resignation – to join competitor
03. Resignation – dissatisfied with job / company / pay
04. Resignation – domestic
05. Resignation – moving from district
07. Dismissed
09. Ill health
10. Retirement
11. Retirement – early
12. Retirement – ill health
13. Deceased
14. Redundancy
15. End of industrial release
20. Maternity
21. TUPE Transfer
22. End of short contract

Payments

Holiday pay due or Days

Pay in lieu of notice or Days

Are there any outstanding payments or absences to be processed, e.g. Overtime, bonus, sickness, etc? Yes No

If ‘’Yes’’, attach to this form

Maternity Leave
a) Attach copy of MAT BI – Date of confinement

b) Date when employee will be commencing her maternity leave

Authorised signature

General Manager