Instructions: This form is to be completed by the supervisor or department representative before an   employee’s last date of employment at XXX. Place a check in the box after each item has been returned. If a particular item does not apply, write N/A to the left of the box. After you    have completed this form, sign it and return it to YYY.  It will be placed in the employee’s personnel file. Employee Name: ______________________________________ Date: _____/_____/_____ Department: ___________________________   Supervisor: _________________________ Position: __________________  Dates of Employment:  From: ___/___/___ to___/___/___ Where to send W-2: _________________________________________________________ The following items have been returned:  Keys  Company Equipment/Laptop Computer  Company […]