For the field, use PS Form 337, Clearance Record for Separated Employee. etc.). A separating employee should also provide a current mailing address to Human Resources to ensure their W2 is received in January following their separation. Once the email template is received in HRSC, if any of the items in the Checklist of departmental actions have been left unchecked,a copy of the SCF will be forwarded to appropriate campus service department.
If the form is not submitted on or before the employee’s last day of work, or after the payroll deadline, the employee’s vacation and sick payouts, if applicable, will be deferred until the next available payroll to ensure that any University property the employee may possess may be retrieved. The Department of Health and Human Services (HHS) uses Form HHS-419, "Clearance of Personnel for Separation or Transfer," to document all employee … Mailing AddressHuman Resources Service Center400 W. First St.Chico, CA 95929–0010. If a department or employee would like an itemized list of keys that have been issued, they can send a request to. If this is NOT possible, then the AAS or ASC can notify Lt Corinne Beck by email to request property drop off with the University Police; be sure to copy the appropriate department manager or college Dean or Chair. Human Resources will process your request in Employee Self Service for you. Human Resources will process your request in Employee Self Service for you. These are items that could potentially cost the department or are required. Retirement:  Separation from the University that is initiated by the employee who meets the age and service requirements established by State Teacher's Retirement Systems (STRS) or Ohio Public Employees Retirement System (OPERS).
The supervisor's failure to comply with the requirements of CD-126, Separation Clearance Certificate and/or the policies as stated in DAO 202-299, Clearance of Employee Accountability, may result in disciplinary action. If it is determined that a separating employee needs to go through this process, all the steps need to be completed (NOS, EN, SCF and Separating forms). Estimated Last Day Worked – This is the last day the employee will be completing work and require access to building and specialized computer applications. If you are unable to use the email template, copy and paste the verbiage below into an email: Subject: Separating Employee Information and Actions. Employees on Leave of Absence or Short Work Break – This separation clearance process is not required for people on leave. This page provides information regarding the requirement to and the steps for completing the Notice of Separation (NOS), Employee Notification, Separation Clearance Form (SCF) and separation action forms that complete the separation clearance process.

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