Breadcrumb
Staff & Administrators Separation & Resignation
Responsibilities
- It is the responsibility of the appropriate administrator or their designee to initiate the separation process via the Form 109
- It is the responsibility of the employee to route the Separating Clearance Form.
Considerations
- Check if any sick days or vacation days will be taken (important for final absence reporting and vacation payout projections)
- Confirm last day physically working
- Confirm last day on pay status
This process involves two parts:
- Completion of the Form 109
- Routing of the Separating Clearance Form
This process should be initiated when the final separation date has been established but no later than 2 weeks prior to separation.
Part 1: The Form 109 and Separating Resources
- Administrator or designee completes Form 109 located at Report of Separation for Staff - (Electronic) | Cal Poly Humboldt Forms
- Form 109 Notification of Separation is dynamically routed for approval.
- Manager reviews the following resources:
- HR/Payroll receives the approved Form 109.
- Payroll separates the employee in Peoplesoft.
- Peoplesoft access is then removed for the separated employee
Part 2: The Separating Employee Clearance Form
There are two forms for separation employees that are automatically sent when completing the Form 109:
- Campus: Separating Employee Clearance Form
- Housing: Separating Employee Clearance Form
For CAMPUS employees:
STEP 1: Employee completes the employee portion of the form.
STEP 2: Employee to coordinate with manager or designee in the appropriate department to return university-owned materials and equipment.
Including:
- Laptop (home department)
- Library books or equipment (Library)
- Other equipment (home department/other)
STEP 3: Employee works with the Cashiers Office to return the following:
- The Separating Employee Clearance form
- Employee identification card
- Key(s): (the Cashiers Office will have a list of keys to return)
- Parking permit
- ProCard
- Travel Card
- Other (as noted by manager)
The Cashier’s Office will determine any outstanding financial obligations for the employee.
NOTE: All keys must be returned to Facilities Management. Do not return keys to your department.
Cashier's Office: SBS Building, 2nd Floor. Monday - Friday 8am - 4pm.
Important notes:
- If the employee is not available to complete the process, the appropriate administrator or their designee must complete the process for them as outlined above.
- If the employee is a faculty member, the appropriate administrator should contact aps@humboldt.edu for instructions.
- If the employee is in housing, they will follow the housing process.
- The Separating Employee Clearance form will be routed to HR, ITS, and Facilities Management.
Forms & Guides
- Form 107: Application for Leave of Absence
Application for Leave of Absence for Staff and Management Employees - Please print on pink paper - Form 109 - Report of Separation Approval Guide
- Form 109 - Report of Separation for Staff & Managers
Do not use this form for Faculty - Form 109 - Report of Separation Form Submission Guide
- Manager's Digital Resources Checklist for Separating Employees
Checklist to assist managers in identifying digital resources that require attention when an employee separates from their unit or the University, including leaves of absence. - Separating Employee Clearance Form
Must be completed before final pay check is issued. This Form IS NOT for continuing FERP or Reappointed Faculty/Staff. - Separating Employee Clearance Form - Housing & Dining Services
This form must be completed before final pay check is issued.