CONFIDENTIAL
[COMPANY LETTERHEAD]
Date: [MONTH] [DAY], [YEAR]
Via [Method of Delivery: Hand, Certified Mail, Email]
[EMPLOYEE NAME]
[EMPLOYEE ADDRESS]
[City, State ZIP]
Re: Notice of Employment Termination and Final Pay Statement
TABLE OF CONTENTS
- Document Header
- Definitions
- Operative Provisions
3.1 Termination of Employment
3.2 Final Compensation
3.3 Health-Insurance Continuation (COBRA / Cal-COBRA)
3.4 Unemployment Insurance Information
3.5 Return of Company Property
3.6 Confidentiality & Other Continuing Obligations - Governing Law & Forum Selection
- Employee Acknowledgment & Execution
1. DOCUMENT HEADER
This Notice of Employment Termination and Final Pay Statement (the “Notice”) is issued by [COMPANY LEGAL NAME], a [State of Incorporation] corporation (“Company”), to [EMPLOYEE NAME] (“Employee”) pursuant to the California Labor Code, California Unemployment Insurance Code, and applicable federal law. The Notice is effective as of [EFFECTIVE TERMINATION DATE] (the “Termination Date”).
2. DEFINITIONS
“Accrued Vacation” – All earned but unused vacation or PTO through the Termination Date calculated under Company policy and paid pursuant to Cal. Lab. Code § 227.3.
“COBRA Administrator” – The third-party administrator or internal department that will issue Employee’s COBRA/Cal-COBRA election materials.
“Final Pay” – All wages, salary, overtime, commissions earned, Accrued Vacation, and reimbursable business expenses through the Termination Date, payable in accordance with Cal. Lab. Code §§ 201 & 203.
“Company Property” – All physical and electronic property of Company, including but not limited to keys, ID badges, credit cards, computers, devices, documents, and confidential information.
3. OPERATIVE PROVISIONS
3.1 Termination of Employment
Effective as of the Termination Date, Employee’s at-will employment with Company is terminated. This action does not alter any post-employment obligations arising under previously executed agreements or applicable law.
3.2 Final Compensation
(a) Delivery. Enclosed with this Notice is Employee’s Final Pay OR Final Pay will be made available at the termination meeting via check or direct deposit ([select method]).
(b) Itemization. A wage statement detailing all payments, deductions, and Accrued Vacation accompanies the Final Pay in compliance with Cal. Lab. Code § 226.
(c) Taxes. All payments are subject to required withholdings.
[// GUIDANCE: If commissions or bonuses are calculable after separation, insert a clause describing post-termination calculation and payment timetable.]
3.3 Health-Insurance Continuation (COBRA / Cal-COBRA)
(a) Eligibility Notice. Within 14 days (for federal COBRA) or the period required under Cal-COBRA, Employee will receive a separate election packet from the COBRA Administrator detailing continuation-coverage rights under 29 U.S.C. § 1161 et seq. and Cal. Ins. Code § 10128.50 et seq.
(b) Premium Payments. Employee is responsible for timely remittance of premiums as outlined in the forthcoming notice. Late or missed payments may result in loss of coverage.
3.4 Unemployment Insurance Information
Pursuant to Cal. Unemp. Ins. Code § 1089, Company encloses the pamphlet “For Your Benefit, California’s Program for the Unemployed” (DE 2320). Eligibility for unemployment compensation is determined solely by the California Employment Development Department (“EDD”).
3.5 Return of Company Property
(a) Deadline. All Company Property must be returned to [RETURN LOCATION/CONTACT] no later than the Termination Date, or [NUMBER] business days thereafter with prior written approval.
(b) Withholding. Failure to timely return Company Property may result in appropriate civil remedies; however, wages will not be withheld except as permitted by law.
3.6 Confidentiality & Other Continuing Obligations
Employee remains bound by all confidentiality, non-solicitation, invention-assignment, and similar covenants previously executed. Nothing in this Notice is intended to diminish Employee’s rights under the California Labor Code or federal law, including the right to disclose information about unlawful acts in the workplace under Cal. Lab. Code § 1102.5.
4. GOVERNING LAW & FORUM SELECTION
This Notice shall be governed by, and construed in accordance with, the laws of the State of California without regard to conflict-of-law principles. Any dispute arising out of or relating to this Notice shall be brought exclusively in the state courts located in [COUNTY], California.
5. EMPLOYEE ACKNOWLEDGMENT & EXECUTION
Please sign below to acknowledge receipt of this Notice and the enclosed materials. Refusal to sign does not affect the finality of termination.
[// GUIDANCE: Retain a signed copy in the personnel file and provide a duplicate to Employee.]
| FOR THE COMPANY | EMPLOYEE ACKNOWLEDGMENT |
|---|---|
| By: _________ | I, [EMPLOYEE NAME], acknowledge receipt of this Notice, the “For Your Benefit” pamphlet, and my Final Pay as described herein. |
| Name: [AUTHORIZED SIGNATORY] | |
| Title: [TITLE] | Signature: ______ |
| Date: ______ | Date: ________ |
[// GUIDANCE:
1. Attach the following:
• Final paycheck (or confirmation of direct deposit).
• Itemized wage statement.
• “For Your Benefit” pamphlet (DE 2320).
• COBRA/Cal-COBRA election notice (or confirmation it will follow).
-
Conduct the termination meeting in a private setting, have a witness present, and document any questions or requests made by Employee.
-
If a separation or release agreement is contemplated (e.g., severance in exchange for a general release), issue it under separate cover to maintain clarity between statutory notices and contractual offers.
]