Employee Departure Form Employee's PMP Please close out the employee's current PMP prior to the last day in the department and send PMP and other documentation you may have that needs to be placed in the Personnel File, including PMP in progress to HR. Please note that resignation letter must be sent to Human Resources immediately upon submission. Departure Date* Departure Time* : HH MM AMPM Name* First Name Last Name Location/Department Does email need to be forwarded?* Yes No If yes, to whom? Does associate have a Salesforce account?* Yes No If associate is a CICS user, what is the userid? Does a network jack need to be turned off?* Yes No Third Choice Please note this applies only to Curtis Building and AJLA associates. If yes, what is the room number of the network jack? What is the Jack number? Located on the card outside the office Does a desk phone need to be disconnected?* Yes No This applies only to Curtis Building associates If yes, what is the phone number? Devices Please enter the required information for any devices that need to be returned. If the associate is located in Curtis, please return the devices before departure. If the associate is in another office, please make arrangements for equipment to be returned as soon as possible. Desktop Model Service Tag Yellow Tag Laptop Model Service Tag Yellow Tag iPad Model Service Tag Yellow Tag Surface Model Service Tag Yellow Tag Tablet Model Service Tag Yellow Tag MiFi Number Cell Phone Number Cell Phone Lock Passcode iTunes User ID iTunes Password FOR CURTIS AND TOPEKA WORKFORCE CENTER ASSOCIATES: Has Capitol Complex key card been returned to the building services manger?* Yes No FOR FIELD OFFICE ASSOCIATES: Have building pass cards been deactivated or returned to supervisor?* Yes No Has key check form been updated and filed?* Yes No Was the associate a fuel card holder?* Yes No If yes, was the card returned to Fiscal?* Yes No Was the associate a P Card holder?* Yes No If yes, was the card returned to Fiscal?* Yes No Are there any open Travel Expense reports for which the associate is waiting for payment?* Yes No Additional Comments: CAPTCHA Name This field is for validation purposes and should be left unchanged.