Audit

EMPLOYEE INFO

Name (Type here or use Sign option to write):

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Today's Date:

ID# (Type here or use Sign option to write):

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Category:

REASONS FOR SEPARATION (More than one can be checked).
NOT FOR REHIRE

Comment / State Reason (Type here or use sign option to write):

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Supervisor Name (Type here or use Sign option to write):

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Supervisor Title:

Supervisor Phone (Type here or use Sign option to write):

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Project Title:

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Supervisor signature:
Employee Signature:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.