Notification of Resignation/Termination


The individual identified below has ended or will end employment on the date indicated below:
First Name	(Required) (as it appears on payroll records)
Last Name	(Required) (as it appears on payroll records)
UIN	(Required) *Example: ###00####*
City	(Required)
Building name	(Required) (HPEB, Reynolds, BCD, etc.)
Position Title	(Required)
ADLOC	(Required)
Last Active Workday	*Example: mm/dd/yyyy*
Retaining Student Status	Yes No (Required)

Account Access	Disable all access (building, computer, email) at close of business on date above OR Exception to immediate removal of all access is requested, specifically: Retain all access - building, computer, email, etc Retain building and computer access, but disable email account. Disable building access; Retain computer access and email until Date:
Provide justification for exception (Examples: Departing employee still in student status, department wishes to continue collaboration on a project, or the employee is transferring within the HSC, etc.) For additional information or assistance please contact Human Resources at (979) 458-7280 or hr@tamhsc.edu.

Justification:
Notification Submitted by:	(Required)
E-mail Address:	(Required)