This form should be completed only AFTER the Exit Interview has been conducted. "*" indicates required fields The submission of this questionnaire triggers an immediate email notice to questionnaire recipients. Questionnaires should not be completed prior to the actual termination. If you are concerned about system access related to the termination, please contact HR for assistance. Effective Date MM slash DD slash YYYY Name of Terminating Employee* First Last Position/Title* Employee ID/Clock Number* Property Name or Office Location* Regional Office*San FranciscoSacramentoSouth BayLos AngelesSupervisor Name (Request Submitted By)* Confirmation Email Address (Submitter's Email)* Boston Post UsernameN/ADeleteChange PasswordBackground Check/Applicant Tracking DisableN/AYesMRI UsernameN/ADeleteChange PasswordShareFileChange PasswordDeleteNexus UsernameN/ADeleteDelegateDelegate Nexus Username to? jsco.net Email AddressN/ADeleteForwardChange Passwordjsco.net Email Address Delete Date* MM slash DD slash YYYY jsco.net Email To Be Forwarded To* Former Employee company-issued Mobile Phone Number* Has the company-issued phone been recovered from the former employee?*YesNoShould the phone be marked as LOST/STOLEN?*YesNoSaying YES, will not wipe the phone but will render it unusable, and the property will be charged for that phone and the replacement phoneShould the phone line be cancelled?*NoYesLine cancellations should be processed when this position will not be re-filled, or Employee is staying with a property leaving JSCo Management. Early line cancellations and prorated charges will apply.Should the phone be WIPED?* Yes No Notes Δ