Forms - HR - PBF Separation Notice

Name*

First Last Pin

Hire Date*

Last check date*

Market Number*

Supervisor*

Phone*

Last Date Worked*

Was this employee driving?*

Reason for Separation (Voluntary)

Reason for Separation (Involuntary)

Would you Rehire?*

If other, list reason for separation.

Confidential Evaluation of Employee

Attendance*

Cooperation*

Initiative*

Quality of Work*

Productivity*

Work Habits*

Relationships*

Comments*

Evaluation Summarized by*

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