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Employee Exit Formality Form

This confidential employee exit interview form collects information about an employee's reasons for leaving, plans after leaving, and feedback on their employment. It asks for their start and end dates, positions, salaries, primary reason for leaving such as a new job or dissatisfaction. Feedback is solicited on what they liked most/least, pay and benefits, satisfaction with opportunities, recognition, training, management, and policies. Suggestions for improvements are also requested. The form is signed by the employee and interviewer.

Uploaded by

Rajeshree Hankare
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
280 views

Employee Exit Formality Form

This confidential employee exit interview form collects information about an employee's reasons for leaving, plans after leaving, and feedback on their employment. It asks for their start and end dates, positions, salaries, primary reason for leaving such as a new job or dissatisfaction. Feedback is solicited on what they liked most/least, pay and benefits, satisfaction with opportunities, recognition, training, management, and policies. Suggestions for improvements are also requested. The form is signed by the employee and interviewer.

Uploaded by

Rajeshree Hankare
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

CONFIDENTIAL

EMPLOYEE EXIT INTERVIEW FORM

Date:

Name: Employee ID:

Location/Department: Team Leader:

Hire Date: Resignation Date:

Starting Position: Ending Position:

Starting Salary: Ending Salary:

PART l: REASONS FOR LEAVING

More than one reason may be given if appropriate; if so, circle primary reason.

RESIGNATION
Took another position Dissatisfaction with salary
Pregnancy/home/family needs Dissatisfaction with type of work
Poor health/physical disability Dissatisfaction with supervisor
Relocation to another city Dissatisfaction with co-workers
Travel difficulties Dissatisfaction with working conditions
To attend school Dissatisfaction with benefits
Other (specify)

LAID OFF RETIREMENT (If applicable)


Lack of work Voluntary retirement
Abolition of position Disability retirement
Lack of funds Regular retirement
Other (specify)

Plans After Leaving

2019/05/03
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PART ll: COMMENTS/SUGGESTIONS FOR IMPROVEMENT
We are interested in what our employees have to say about their work experience with Stockaxis. Please complete
this form.

1. What did you like most about your job?

2. What did you like least about your job?

3. How did you feel about the pay and benefits?


Excellent Good Fair Poor
Rate of pay for your job
Paid holidays
Paid vacations
Retirement plan
Medical coverage for self
Medical coverage for dependents
Life insurance
Sick leave

4. How did you feel about the following:


Very Slightly Slightly Very
Satisfied Satisfied Neutral Dissatisfied Dissatisfied
Opportunity to use your abilities
Recognition for the work you did
Training you received
Your team leader’s
management methods
The opportunity to talk with your
team leader
The information you received on
policies, programs, projects and
problems
The information you received on
departmental structure
Promotion policies and practices
Discipline policies and practices
Job transfer policies and practices
Overtime policies and practices
Performance review policies and
practices
Physical working conditions

2019/05/03
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COMMENTS:

5. a) If you are taking another job, what kind of work will you be doing?

b) What has your new place of employment offered you that is more attractive than your present job?

6. Could Stockaxis have made any improvements that might have influenced you to stay on the job?

Other remarks (optional):

Employee’s Signature Date


RESET FORM PRINT FORM
DO NOT WRITE BELOW THIS LINE. OFFICE USE ONLY.

( ) Discussed with employee


( ) Right to file for unemployment benefits
( ) Conversion of benefits
( ) If retiring, state option for payment of unused leave

Interviewer’s Signature Date

2019/05/03
Page 3 of 3

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