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Get Wayland Baptist University Date: Name Social Security # Termination Report Form Title

OFFICE/DIVISION OF EMPLOYMENT Date of Last Day to be WORKED: Estimated VACATION LEAVE ACCRUED at this Date: Type of Separation: Resignation Attach letter of resignation or detail reasoning below Dismissal Attach notification(s) or detail reasoning below DETAILED REASONING of Resignation or Dismissal or Other COMMENT: CLEARANCE PROCEDURES (Must be completed before the final paycheck will be issued): 1. Division Chairperson/Director/Super.

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