Penn State Fayette logo
Termination Request Form

*For Internal Use Only* - This form should be completed two weeks prior to an employee terminating or as soon as the details are known, whichever is earlier.  Please complete as many fields on this form as possible for the most efficient processing.


Employee Information


Access and Asset Information


I have completed this form to the best of my knowledge and with the most accurate information available to me.
(Both fields below are required)

Your Full E-mail Address: (required)


Prior to submitting this form electronically, you must print HR102.pdf and give it to the supervisor of the employee. The supervisor is to complete the supervisory items as highlighted, sign the form and send it to the Business Office.