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Separation from Agency Checklist
Printable Separation from Agency Checklist
Resignation/Retirement/Termination
All Separations
Printable Separation from Agency Checklist
Click Link for Printable Separation from Agency Checklist form (PDF)
 
This checklist is intended to help the supervisor to revoke access to systems and programs and ensure all DOC property is collected from the employee.
 
Note: Transfers within the Agency, use Transfer Checklist. 
Resignation/Retirement/Termination
Select Type:
  Resignation
  Exit Survey Retirement Resignation & Transfer Out (Survey Monkey)
  Transfer to another Agency (Transfers within the Agency, use Job Rotation Transfer Checklist)
  Retirement
  Termination
   
Furlough Requirements
  Supervisor will verify employee has taken required number of furlough days
   
Termination Only
HR Manager
  Review Termination Letter
Supervisor
  Send/Deliver Termination Letter
   

All Separations
HR Personnel Records
  Resign/Retire/Transfer Form CD1501 or 
  Resign/Retire only - Letter
  Termination Letter
   
Payroll
  Timesheet
     Work with Payroll Technician for final Paycheck
   
DOC Property Returned to Manager
  Employee Assigned Property Tracking CD1489 
  DOC Photo ID
  Keys/Key Fob
  Key Chits/Card
  Cell Phone/Mobile Device/Chit 
  Pager
  PDA
  Laptop
  Memory Stick (Flash Drive)
  Secure ID Card (RSA Token Hard/Soft)
  Cards
        Phone
        DAS Motor Pool
        Spots
        Voyager
  Termination - Uniform and Equipment
   
Information Technology Services
  User Authorization Form to Revoke Access 
     Systems
     Programs
     Distribution Lists
     Other
  Secure ID Card (RSA Token Hard/Soft)
   
Accounting/Contracts/Purchasing
Revoke Expenditure Delegation CD1439 
  Request to Use Private Vehicle CD1404 
  SPOTS Card Application Form 75.55.02.F.4
  Voyager Card CD1500 
  Contracts Signature Authority CD1482 
  ORPIN (DOC ORPIN User Authorization Form)
  Zephyr (DOC User Authorization Form)
  OSPS (DOC User Authorization Form)
  SFMA (DOC User Authorization Form)
  DataMart/Hyperion(DOC User Authorization Form)
  DAS Systems Security (DOC User Authorization Form)
  Trust/Commissary System Access (DOC User Authorization Form)
  Treasury (Link)
   
Specific to Facility/Institution/Position
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   

Page updated: June 07, 2011