Separation Notice - City of Albany, Georgia - albany ga 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the employee's name in the first field as it appears on official records. If there are any alternate names, include them in the designated area.
3. Input the employee's Social Security Number accurately in the second field to ensure proper identification.
4. For the period of last employment, fill in the 'From' and 'To' dates to indicate when the employee worked.
5. Select the reason for separation. If it is due to lack of work, check that box; otherwise, provide detailed circumstances in the space provided.
6. If applicable, specify any payments made to the employee such as severance or wages-in-lieu of notice, including amounts and payment dates.
7. Indicate whether the employee earned at least $3,000 during their employment by checking 'YES' or 'NO', and if 'NO', enter the amount earned.
8. Complete employer information including name, address, and contact number. Ensure all details are accurate for future correspondence.
9. Finally, have an authorized person sign and date the form before handing it over to or mailing it to the employee.

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