Research Corporation of the University of Hawaiʻi

Research Corporation
of the University of Hawai‘i
Human Resources Department
Termination of Employment Form
Employee’s Name _________________________________________ RCUH Employee ID# __________________
Forwarding Address (for W-2 distribution) ____________________________________________________________
Employee Status: [ ] Regular [ ] Temporary [ ] Student [ ] Intermittent
[ ] Other: ___________________________________________________________________
Date Employee Notified ________________ Last Day Worked _______________ Termination Date ____________
PART I: VOLUNTARY RESIGNATION (To be completed by employee or supervisor)
I hereby submit my resignation because of: [ ] Return to school
[ ] Relocation
[ ] Acceptance of another position.
If position is with RCUH, denote project name and job title:______________________________________ [ ] Other: _______________________________________________________________________________________
I acknowledge and certify that the information present above is true and accurate.
______________________________________________________________________________________________________ Employee’s Signature Date
PART II: INVOLUNTARY TERMINATION (To be completed by project)
Involuntary Terminations must be signed by Principal Investigator of record.
ATTACH COPY OF 10 DAY NOTICE TO EMPLOYEE
Employee is terminated because of:
[ ] End of temporary employment
[ ] Ineligible for work (student or visa expiration)
[ ] Layoff (due to lack of work/funds)
[ ] Discharged. Explain and attach pertinent document(s) ___________________________________________
[ ] Other: ______________________________________________________________________________________
PART III: REVIEWED AND AUTHORIZED (To be completed by project)
[ ] Full vacation payout (default option paid from the RCUH Vacation Payout Reserve)
[ ] Termination vacation (contingent upon Principal Investigator’s approval and availability of funds)
[ ] Transfer/no break in service (transfer vacation hours)
[ ] Not applicable (non-recruited hire/regular hire less than 50% FTE appointment)
______________________________________________________________________________________________________ Principal Investigator [Please Print]
______________________________________________________________________________________________________ Signature of Principal Investigator Date
PART IV: RCUH HUMAN RESOURCES APPROVAL (To be completed by RCUH)
I certify that to the best of my knowledge, the personnel action above has been made in compliance with all RCUH policies, applicable laws, and statutes of the State of Hawaii.
______________________________________________________________________________________________________ Director of Human Resources or Designee Date
RCUH Form D-3, Revised 08/98, 04/08, 6/16