Form Categories
Form Title Category
COBRA Election Form

This form provides notice to qualified beneficiaries describing rights to continuance health care insurance coverage after termination of employment and how to make an election. Employers with 20 or more employees that provide health insurance to their employees are to provide this form to terminating employee.

Termination
[ Updated: 04/23/2018 ]
EDD Notice

This is a government form prepared by Employment Development Department to be provided to employees at the time of termination notifying them of the EDD programs and benefits offered to unemployed Californians.

Termination
[ Updated: 04/27/2018 ]
Exit Interview Form

This is a sample exit interview questions for separating employees.

Termination
[ Updated: 04/23/2018 ]
Final Pay Acknowledgment

This is a sample acknowledgment to be signed by separating employee certifying that he or she received all wages due at the time of termination; that he or she was provided with opportunities to take meal and rest periods; and that he or she has not sustained any work-related injuries that they had not reported.

Termination
[ Updated: 04/23/2018 ]
Health Insurance Premium Payment Program Notice (DHCS 9061).

This is a government form for employers with 20 or more employees that provide health insurance who are required to give terminating workers a special notification about the state sponsored HIPP program. This notice is in addition to any COBRA notices and applies to both private and public employers.

Termination
[ Updated: 04/27/2018 ]
Notice of Job Abandonment

This is a sample notice to employee who fails to report to work for consecutive number of days effectively abandoning his or her position.

Termination
[ Updated: 04/23/2018 ]
Notice to Employee as to Change in Relationship.

This is a government form to be provided to separating employee for unemployment benefit claim purposes. The form specifies the date of termination and notifies employee and the EDD of the change in relationship.

Termination
[ Updated: 04/27/2018 ]
Resignation Confirmation Form

This is a form confirming employee’s verbal resignation and notifying the employee of the company’s acceptance of resignation.

Termination
[ Updated: 04/23/2018 ]
Separation Letter

This letter confirms termination of employment with the company on stated date.

Termination
[ Updated: 04/23/2018 ]
Severance and Release Agreement (Over 40)

This is a sample release agreement for employee over 40 years old who is releasing any and all claims against the company in exchange for severance pay.

Termination
[ Updated: 04/23/2018 ]
Severance and Release Agreement (Under 40)

This is a sample release agreement for employee under 40 years old who is releasing any and all claims against the company in exchange for severance pay.

Termination
[ Updated: 04/23/2018 ]
Termination Checklist

This is a sample checklist of notices and forms to be provided to employee at the time of termination of employment.

Termination
[ Updated: 04/23/2018 ]
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