Separation Form EJBR InvestmentsEAN 6753593 Restaurant No. * 51 54 55 56 59 60 63 64 65 66 67 72 74 75 76 78 Employee Name * First Name Last Name Last Day of Work * MM DD YYYY Reason for Separation * Voluntarily Quit Discharged/Fired Did not return from leave after approved FMLA leave Deceased Explain Briefly: Why did they quit? Why were they discharged? * IF THIS SEPARATION WAS A DISCHARGE, PLEASE SEND DOCUMENTATION TO: hr@maclaff.com Would you rehire? * YES NO If you would NOT rehire, WHY? * Name of Manager sending this form * Thank you!
