Notice of Change in Relationship (English/Spanish) - Western United ... 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and employee number in the designated fields at the top of the form.
3. Select the reason for the change in employment status by checking the appropriate box. Options include voluntary quit, layoff, leave of absence, demotion, discharge, refusal to accept work, or a change to independent contractor status.
4. For each selected reason, fill in the effective date next to it. If applicable, provide an anticipated return date for leaves of absence.
5. In the comments section, add any additional information regarding your employment status change that may be necessary.
6. Ensure that both you and a company representative sign and date the form at the bottom to acknowledge receipt and agreement.

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