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Get Separation Certificate

N Please read the information on page 2 before completing this form. Employee details Surname Given names Date of birth (dd mm yyyy) e.g. 12 May 1980 Address Date employee started working for you Postcode Date employee last worked for you Was employment terminated due to: Please give reason Shortage of work or redundancy Unsatisfactory work performance Unsuitability for this type of work Misconduct End of season or contract Employee ceasing work voluntarily Other Has a claim been ma.

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