UUCUC Staff Offboarding Checklist

Name *

First

Last

Personal Email Address *

Please use an email account where you can be reached after employment should UUCUC need to contact you.

Personal Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Please use an address where you can be reached after employment should UUCUC need to contact you.

By checking each box below, you acknowledge that you have completed the checklist item and/or you are in agreement with the statement noted:

The checkbox for each item noted below is required to be selected prior to submitting this agreement. If you disagree with any item or have additional questions before submitting this agreement, please reach out to UUCUC's Director of Business Administration at admin@uucuc.org.

Keys *

All keys to the Church building, closets, instruments, or other secured church items have been returned to the Director of Business Administration or Facilities Manager.

Charge Cards *

All charge cards belonging to UUCUC have been returned to the Director of Business Administration, with a statement of the balance.

Purchases and Expenses *

All authorized purchases or other expenses on behalf of UUCUC to date of resignation are documented via receipt and applicable forms for credit card reconciliation or reimbursement have been submitted to the Director of Business Administration.

Personal Information *

Personal information, including all personal files, have been deleted from computers owned by UUCUC.

Files *

All important paper and computer files are readily accessible and organized, and passwords to any computers have been shared with your direct supervisor or Director of Buisness Administration.

Office equipment *

All books, computer(s) and other equipment, including software purchased at UUCUC expense, have been returned to your director supervisor or Director of Buisness Administration.

Final wage and salary payment *

You have signed the receipt for any final wage/salary payment due (please refer to your offboarding letter).

Were you informed in your offboarding letter that you will be receiving severance pay in addition to your final wage/salary payment? *

Yes
No

Taxes and Severance Pay *

You have been informed that federal and state taxes are removed from any severance payment (please refer to your offboarding letter).

Retirement plan and severance pay *

You have been informed that retirement plan contributions may not be made based on severance. This is a federal restriction.

Termination of benefits *

The staff member has been informed that all benefits lapse at the termination of employment (please refer to your offboarding letter).

Were you enrolled in UUA's retirement plan? *

Yes
No

UUA retirement plan point of contact *

You have received contact information concerning your UUA retirement plan: Richard Nugent, Director of the Office of Church Staff Finances: (617) 948-6456, rnugent@uua.org. OR call TIAA, 1-800-842-2829 to request a rollover (please refer to your offboarding letter).

Personal items *

All personal items have been removed from Church property.

Breeze, Distribution Lists, and Facebook *

You agree to being removed from the Friend list in Breeze, unless remaining in congregation, and removed from all Google Groups and private Facebook groups.

Did a representative of the Personnel Committee or the Lead Minister schedule an exit interview with you? *

Yes
No

Exit *

Exit interviews agreed upon by you and the Personnel Committee point of contact or Lead Minister have been scheduled or completed.

Resignation Letters *

You agree that copies of your resignation / termination letters have been placed in your Personnel file, with the original being sent to you and a copy to the Director of Business Administration for purpose of salary and severance.

UU Church of Urbana Champaign

UU Church of Urbana-Champaign

Sunday Services: 10.15am

By checking each box below, you acknowledge that you have completed the checklist item and/or you are in agreement with the statement noted: