Departure Form

Employee Info

Date

Please select the blue button to find your employee.

Last Name

First Name

Work Email

Work Phone (format: 000-000-0000)

Region

Branch

Please select the blue button to find a building.

Buildings / Sites

User Location

Employ. Class

Manager's information

Is the employee's manager absent?

Departure Info

Departure Type

Name of New Federal Organization

IT Account Deactivation Date

Manager Comments

Site-Secure