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Staff Leaver Form
Don't Send hard copies of this form. At the end of submission, you will get a link, save it!
Company
*
Please Select
Hala Farnborough Ltd
Jgs Pizza Ltd
Sas Pizza Ltd
Newtex Pizza Ltd
Store
*
Please Select
Aldershot (Hala)
Fernhill (Hala)
Farnborough (Hala)
Fleet (Hala)
Frimley (Hala)
Bordon (Jgs)
Hindhead (Jgs)
Evesham (Jgs)
Cheshunt (Sas)
Waltham Abbey (Sas)
Morley (Newtex)
Horsforth (Newtex)
Leavers Full Name
*
Prefix
First Name
Last Name
Notice Given
*
Please Select
Late leaver
Disciplinary
No Notice Given
1 Week
2 Weeks
3 Weeks
4 Weeks
Leaving Date
*
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2014
2013
Year
You need to get the Auth code to put through the leavers form as its more than 14 days from today.
Auth Code for late form
Last Payment Method
*
Please Select
Cheque
Bacs
If Cheque to above, advise on collection
Please Select
Post to Employee
Post to Store
I will collect in person
Handover to Area Manager
If Resignation letter given by employee, Scan this
Confirm if the employee is leaving the UK?
*
Yes
No
If yes to above, any person to act on behalf?
Prefix
First Name
Last Name
Forward P45 to
*
Please Select
Employee Address
Store
I will collect in person
Person acting on behalf of leaver
Retain in Office until further notice
Forwarding Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Uniform Return and Deductions
Option C deducts the uniform from leaver straight away
Uniform Returned
*
A)Yes
B)Not at present, but will
C)No,Cant get hold of
Uniforms (A)
prev
next
( X )
Shirt
£
11.34
No
1
2
3
4
5
6
7
8
9
10
Badge
£
1.20
No
1
2
3
4
5
6
7
8
9
10
Hat
£
3.13
No
1
2
3
4
5
6
7
8
9
10
Belt
£
5.50
No
1
2
3
4
5
6
7
8
9
10
Total
£
0.00
Uniform Deduction (B)
Please Select
Please deduct uniform
Please dont deduct uniform
Future Reference
Please provide us with your thoughts on this leavers performance. This will help us respond to any references this leaver may get in future
Would You Reemploy This Staff?
*
Please Select
Yes
No
May be
How good the staff was?
*
Please Select
Very Good
Good
Satisfactory
Bad
Very Bad
Your Thoughts on Staffs Satisfactory Record
Your Thoughts on Staffs Unsatisfactory Record
Submitting Managers Name
First Name
Last Name
Store Email for Submission proof
*
Manager Signature
*
Employee Signature
*
Submit
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