Employee Change Form

Required fields are in bold

Contact Information

Company Name
Contact Name
Floor and/or Location
Department
Phone EXT
E-mail
Service Tag (If Applicable)

Change Information

Employee Name
What date is this effective on?
Redistribution of old PC?
If Yes, to whom?
Any personal data that needs saved?
Forwarding address for e-mails
Who needs access to personal or business files/folders?
Date file access and email forwarding will be disabled
Additional Connected Devices
(PDA’s, fax modems, etc.)
Notes