For Completion by the Departing Staff Member, in Conjunction with Their Supervisor

ExitChecklist

For completion by the departing staff member, in conjunction with their Supervisor

Name:______Staff ID No______

Organisational Unit:______Position: ______

Departure Date: ______

NOTIFICATIONS / Completed / N/A
HR
Advise HR of forwarding details (for further correspondence, e.g. PAYG summary)
Ensure that any accumulated flextime credit or debit is eliminated prior to last day (notify HR if this cannot be achieved)
Finalise outstanding leave applications (via Staff Connect)
Complete Exit Questionnaire (may request interview with HR Consultant)
Advise HR if you wish to obtain a Separation Certificate and/or Statement of Service
Advise WHS staff/HR if occupied specialist safety roles (eg WHS Committee Member)
Other
Advise all relevant/affected staff and external contacts of departure
Contact Office of Research re: outstanding grants/ethics applications or other matters
Advise Facilities Management if occupied the role of either Evacuation Warden or First Aid Officer
Undertake other local requirements (please specify):
ITEMS FOR RETURN / Returned / N/A
Facilities Management
Staff ID Card returned/electronic access card
Parking permit/parking access card returned
Keys returned – including building, office, desk, filing cabinet keys (check against Issue Record)
Uniforms/ Personal Protective Equipment returned
IT
IT hardware returned - laptops, computers, projectors etc (circle applicable items)
IT software and manuals returned
Pagers / Mobile Phone/ Camera returned (circle applicable items)
Remove ACU documents from personal computer
Finance
Purchasing Card and related receipts returned
Credit Card and related receipts returned
Fuel Charge Card and related receipts returned
Motor Vehicle, vehicle keys and travel diary returned
Cab charge card/vouchers returned
Other
Departmental files, manuals, books, papers, documents, business cards, course/curriculum and other materials returned (hard copy and electronic)
Library materials returned and any fines paid (confirm with Library staff)
Safety equipment (e.g. safety loan equipment, radiation dose badges)
Other ACU property returned (please specify):

Employee’sName: Signature: Date:

Supervisor’s Name: Signature: Date:

Please note:

This form must be completed and returned to Human Resources() on or before the staff member’s last working day. Final termination payment may be withheld until all items listed above have been notified and/or completed. When leaving the ACU, it is essential to adhere to the Intellectual Property Policy (available on the ACU homepage).