1)EMPLOYEE DETAILS / 2)REASON FOR LEAVING (please tick)
Name: / Retirement*
Resignation*
Transfer to another Faculty/Service
End of Fixed-term contract/funding
Voluntary Severance
Other
*A copy of the notice of retirement or resignation must be attached to this form. If resignation, please provide an indication of the reason, career prospects, personal reasons, relocation.
Faculty/Service:
Job title:
Leaving Date:
(please give the last day of employment)
Redeployeeregistered on Redeployment list?:
YesNo
3) DESTINATION after leaving for HESA purposes, applies to ALL staff
A Working in a higher education institution
Working in another education institution
Working in a research institute (private)
Working in a research institute (public)
NHS/General medical/dental practice
Working in another public sectororganisation
Working in the voluntary sector
Working in the private sector
Self-employed
Registered as a student
Retired
Not in regular employment / B England
Wales
Scotland
Northern Ireland
UK (not otherwise specified)
Other EU
Non-EU
C If you are leaving to work in another HE, please state the name:
4) ANNUAL LEAVE (please tick and enter amount in days or hours)
Arrangements should be made for outstanding annual leave to be taken prior to leaving. If due to business critical operational reasons this is not possible, please confirm the outstanding annual leave entitlement to be paid on termination. Alternatively, where annual leave in excess of the leave entitlement has been taken, please state the excess to be recovered from the final salary payment. Annual leave is calculated on the basis of complete months’ service. Please review the annual leave policy to calculate this:Annual leave entitlement for leave year until end date: days/hours (delete as applicable)
Pro-rata leave entitlement will be used prior to leaving the University
Leave Outstanding: days/hours (delete as applicable)
Excess Leave Taken: days/hours (delete as applicable)
5) TERM-TIME ONLY(TTO) CONTRACT DETAILS (please tick and enter amount in weeks)
If term-time only, please specify number of weeks worked from 1 September or their starting date (if this was after 1 September) to their leaving date:
TTO: Weeks worked:
6) AUTHORISATION
Leaver form complete(please tick):
Name: …………………………………. Signed: ……………………………………… Date: ……….…………….
( Line manager))
Contact Name: ………………………………………… Telephone No: …………………………………………..
(Please provide a contact for enquiries on the above information)
To be completed and returned to the Human Resources via email: