CALIFORNIA STATE UNIVERSITY, EAST BAY
SEPARATING EMPLOYEE CLEARANCE FORM
SECTION 1 - EMPLOYEE INFORMATION (To be completed by the manager)
Employee Last Name
Employee First Name
NETID
Employee ID
Employee Email ID
Employee Type?
Faculty
Staff
FERP
Student
DEPTID
Department
Last Day Worked
Separation Date
Separation Type?
Resignation
Retirement
Other
Reason
Submitted Help Desk Ticket to Information Technology Solutions & Telecom.
RITM #
Access to systems, including email, will be ceased by the
Separation Date stated above
.
Initiate Service Desk Ticket at the
IT Help Desk Webpage
Initiate the eFAF for separating faculty employee:
eFAF Webpage
Initiate the Personnel Transaction Request (PTR) for separating staff employee:
CSUEB at Work
Date Initiated
Submitted SEAF to payroll (for Student Assistants)
Date Initiated
Manager's Email Address