Separation Form CJBR InvestmentsEAN 6753829 Restaurant No. * 50 53 58 61 69 73 77 79 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!
