EMPLOYEE SEPARATION CHECKLIST
员工离职清单
Remark: Please mark N/A if it is not applicable 如不适用，请在相应栏目前标注N/A.
Employee Information员工基本信息
Name
姓名：
Associate’s ID
员工编号：
Department
部门：
Job Title
职位：
Employment Date
受聘日期：
Last Working Day
最后工作日：
DEPARTMENT 本部门
Owner: Department Manager    责任人：部门经理
□  Work summary and handover list (See attachment) 工作总结及交接清单（见附件）
□  Company materials/ Tools/ Equipments 公司物料、工具、设备
□  Job related company confidential documents 保密资料
□  Keys(office, desk, cabinet)
钥匙（办公室、桌子、柜子）
□  Name card名片
□  Black Berry公司黑莓小电脑
exited
□  Removable/U disk可移动硬盘/U盘
□  Computer anti-spy screen电脑防窥屏
□  Mobile phone手机
□  3G/SIM card 3G及SIM卡等
□  Others please specify 其他，请注明：__________________
Checked by 检查人：________________          Date 日期：________________
ACCOUNTING 财务
Owner: General Accounting Manager    责任人：总账会计经理
□  Cash Advance预支款
□  Company paid airline tickets公司已付机票款
□  Credit Card(s) 公司信用卡
□  Other fees that shall be paid off其他应结款项
Checked by 检查人：________________          Date 日期：________________
INFORMATION SYSTEM 信息系统
Owner: IT Manager    责任人：信息经理
□  Computer (including desktop, laptop, workstation) return to IT and in good condition and function well
电脑（包括台式电脑、手提电脑、工作站）返回IT，状态良好能正常使用
□  Desktop phone return to IT and in good condition and function well
桌面电话返回 IT ，状态良好能正常使用
□  Non-shared Fax/Printer/Copier return to IT and in good condition and function
非公用传真机，打印机，复印机返回 IT ，状态良好能正常使用
□  Office purpose software and license return to IT
办公用软件及许可证返回 IT
□  Name removed from Telephone System
将姓名从电话系统移除
□  Name removed from local system Which is not synchronized with GAIMS system
将姓名从没有与GAIMS系统同步的本地系统中移除
Checked by 检查人：________________          Date 日期：________________
EHS 环境健康安全 
Owner: EHS Manager    责任人：环境健康安全经理
□  PPE and uniform个人劳保护具和工作服
□  Physical check for special job特岗离职体检
□  Clinic 医务室
Checked by 检查人：________________          Date 日期：________________
HUMAN RESOURCES 人力资源
Owner: HR Manager    责任人：人力资源经理
□  Exit interview
离职面谈
HR BP/Specialist/Manager
HRBP/专员/ 经理
□  Borrowed books/articles and other documents
培训书籍及资料
□  Training Bond 培训约定
Training Manager/Specialist/
HR Specialist
培训经理/专员/HR专员
□  Compensation and benefits items
薪酬福利事项
Payroll Specialist
薪酬专员
□  Request to delete Lotus Notes/Cityray ID (only for HR staff)
申请取消Lotus Notes/ Cityray （仅适用于HR员工）
□  Request to remove SAP ID by help desk申请取消 SAP 账号
□  Remove Z user ID on GAIMS system
在 GAIMS 中删除 Z User ID
HR System Specialist
HR系统专员
□  Enable non-compete Agreement (Y/N)是否启用竞业限制协议
□  Employee Handbook/ Business Code Conduct
员工手册/业务行为准则
□  ID badge/ Locker key 员工识别卡和更衣箱钥匙
□  Others 其他
HR Specialist
HR专员
Confirmed by 确认人：________________          Date 日期：________________
ASSOCIATE DECLARATION  员工声明：
-I hereby certify that I have completed the above exit process and return all company property.
我确定我已完成上述离职程序，并已归还所有公司财产。
-I further agree to maintain in confidence and keep secret all information which I possess or acquire during my employment with Goodyear which Goodyear uses and which Goodyear intends or is obligated to keep secret.  I agree not to reveal such information to anyone or in any way that may compromise the business and technical effectiveness of Goodyear. I shall bear all the corresponding legal responsibility upon my violation of the above commitments.
我承诺，我将对所有在 公司工作期间所接触的公司使用的、认为需要保密的，或我必须要对其保密的信息保密。我承诺不会将这些信息以任何对公司业务及技术效能有损的方式透露给任何人。如有不实或违反，本人愿承担相应法律责任。
Signature 员工签名：________________          Date 日期：_______________
HR specialist/Vendor Rep. check this Exit Check List before transfer out exited associate's personal relationship .This check list will be kept by HR Specialist and copy to FESCO Rep. if exited associated is contract.
HR专员/派遣公司代表在为各自离职员工办理转移其个人关系和档案时，需核查此离职移交清单。HR专员保存此离职移交清单。如果该员工为派遣员工，需将复印件转交给派遣公司代表。
Attachment附件：Task Delivery待办事项交接单
TASK DELIVERY
待办事项交接单
NO. 序号
Items to do
待办事项
Status
进展情况
Contact
联系人及方式
Taken Signature
接收人签字
Date
签字日期
Department Manager 部门负责人签字：________________          Date 日期：________________

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