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0 Separation Notice Form
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Ensure Accuracy When Employees Leave

Completing the Separation Notice satisfies all the documentation needed when an employee resigns, is laid off or retires. The checklist covers critical issues that must be discussed with an employee upon separation from employment. Completion of this form starts the process for COBRA (Consolidated Omnibus Budget Reconciliation Act) and issuance of final pay.
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  • Walks you through the separation process and ensures you have all the necessary documentation.
  • Also available as a 2-part carbon-free form, so you can keep accurate records of separation proceedings.
  • Four-line imprint available on padded version only
  • Prices listed are per pad, per package
  • 50 sheets/pad
  • Size: 8 1/2" x 11"
QtyModel #Description1-23-56-910+
A0605 Separation Notice
Plain, Pack of 50
$34.99$30.99$28.99$26.99 
A0605 Separation Notice
Imprint Front, Pack of 50
$44.99$40.99$38.99$36.99 
A0972 Separation Notice
2-Part Carbonless, Pack of 50
$59.99$54.99$52.99$50.99 


  • Prices listed are per pad per package. 50 sheets/pkg. Size: 8 1/2" x 11".
  • A customer service representative will call you for imprinting details.
 
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