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Separation from Agency Checklist
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