Employee Details
Full legal name, employee ID, job title, department, direct manager, and contact information to ensure the record matches payroll and benefits systems.
A written, consistent response ensures legal and operational clarity at separation, reduces disputes over final pay or accrued time, and documents employer actions for audit or unemployment claims. It centralizes information for payroll, benefits, IT, and security processing.
HR professionals, managers, and designated payroll or HR administrators typically complete and approve the form when an employee resigns.
The completed form is retained in the personnel file and routed to relevant internal teams to complete separation tasks and regulatory reporting as needed.
Full legal name, employee ID, job title, department, direct manager, and contact information to ensure the record matches payroll and benefits systems.
Date resignation received, employee-stated last day, reason (optional), and whether resignation was voluntary or by mutual agreement.
Confirm final paycheck date, accrued PTO payout, bonuses or commissions due, and any deductions or repayment agreements.
Document benefits end date, COBRA eligibility notice requirements, health plan termination date, and benefits contacts for the employee.
Inventory of returned items (laptop, phone, keys, ID badge), expected return date, and escalation steps for missing property.
Signatures and dates from the employee (acknowledgment) and HR/manager (acceptance) plus any notes about exit interviews or confidentiality reminders.
| Field | Configuration |
|---|---|
| Employee ID Mapping | Auto-fill from HRIS to prevent manual entry errors. |
| Manager Approval | Conditional routing to manager for sign-off before HR finalizes. |
| Payroll Notification | Trigger payroll task with a PDF and computed payout amounts. |
| Asset Recovery Task | Create IT/security ticket when company property is flagged outstanding. |
Use an eSignature-enabled workflow that provides signer attribution, audit trails, and secure storage when collecting electronic acknowledgments.
Ensure the platform used supports retention, export to HRIS, and compliance requirements such as ESIGN and UETA; for healthcare-related records, confirm HIPAA BAA coverage.
Acknowledge receipt promptly, ideally within 1 business day.
Follow state final wage timing rules for payment of last wages.
Send COBRA election information within required federal timelines.
Retain I-9 per federal rule after separation for recordkeeping.
Store completed form as part of the permanent HR record.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial | Varies by plan | Varies by plan | Varies by plan | Varies by plan |
| Bulk Send | Yes | Yes | Yes | Yes | Varies |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | Varies | Varies |