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SEPARATION
NOTICE
FORM
Please contact your payroll advisor at 800-718-7552 opt. 3 or email us at payroll@ocmiwc.com to request a Separation Notice form.
Question #1
Is employee eligible for re-hire with Client?
Question #2
Did employee sign a separation and release agreement?
Question #3
Upon separation did you report or will you be reporting payroll wages for the employee?
(Note: Wages must be reported to your Payroll Specialist.)
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