This section captures comprehensive details about the organizational restructuring initiative and all affected personnel. Complete all fields with precise information to ensure audit readiness and regulatory compliance.
Restructuring Initiative Type
Departmental Consolidation
Functional Realignment
Position Elimination (RIF)
Site Closure/Relocation
Merger/Acquisition Integration
Digital Transformation Workforce Impact
Other
Proposed Effective Date of Restructuring
Employee Notification Date
Impacted Employee Metadata Registry
Employee ID | Current Job Title | Department/Division | Years of Service | Original Hire Date | Last Promotion Date | Latest Performance Rating (1-5) | Protected Class Consideration Flag | |
|---|---|---|---|---|---|---|---|---|
EMP-2025-001 | Senior Operations Manager | Supply Chain Division | 8 | 3/15/2017 | 1/10/2022 | |||
EMP-2025-002 | Business Analyst II | Strategy & Planning | 3 | 6/1/2022 | 3/20/2024 | |||
Business Rationale for Restructuring (include strategic objectives, financial drivers, and operational efficiency goals)
Total Number of Positions Impacted Across All Departments
Total Number of Departments Affected
Does this restructuring involve union-represented employees?
Has a comparable restructuring occurred within the past 24 months?
This section documents the objective, non-discriminatory selection methodology and conducts a proactive disparate impact analysis. Provide detailed justification for each criterion and complete the demographic impact assessment.
Primary Selection Methodology Applied
Seniority-Based (LIFO/FIFO)
Performance Rating Threshold
Skills/Competency Matrix Assessment
Business Criticality Ranking
Geographic/Location-Based
Voluntary Departure Incentive First
Hybrid Multi-Factor Model
Other
Selection Criteria Validation Matrix - Rate each criterion's objectivity, business necessity, and documentation strength
Not Applied | Weakly Documented | Moderately Documented | Well Documented | Exceptionally Documented | |
|---|---|---|---|---|---|
Criterion 1: Seniority/Tenure | |||||
Criterion 2: Performance Metrics | |||||
Criterion 3: Skills/Qualifications Match | |||||
Criterion 4: Business Unit Criticality | |||||
Criterion 5: Attendance/Disciplinary Record |
Detailed Justification for Non-Seniority Based Selection (if applicable): Explain why alternative criteria constitute legitimate business necessity and are job-related
Has a statistical disparate impact analysis been completed?
Were any employees selected for retention despite lower scores on primary criteria?
Alternative Employment Options Considered Before Finalizing Eliminations (select all that apply)
Voluntary Early Retirement Incentive
Voluntary Separation Package
Internal Transfer/Redeployment
Reduced Work Hours/Furlough
Pay Reduction with Equity Compensation
Skill Retraining/Reskilling Program
No alternatives considered - immediate business necessity
Documentation of Decision-Maker Training on Unconscious Bias and Non-Discrimination (include dates, attendees, and training provider):
Upload Selection Matrix Scoresheets and Decision Support Documentation (spreadsheets, performance data extracts)
This section details all financial and benefits-related components of the separation package. Non-standard severance requires enhanced justification and legal review. Ensure all calculations are verified and documented.
Severance Formula Applied
Standard Policy (e.g., 1 week per year of service)
Enhanced Package (above standard)
Statutory Minimum Only
Executive Separation Agreement
Negotiated Settlement
No Severance (for cause termination)
Does this involve non-standard severance terms exceeding standard policy?
Severance Package Component Calculation Matrix
Component Type | Base Amount | Multiplier/Weeks | Calculated Value | Subject to Legal Hold | Payment Timing | |
|---|---|---|---|---|---|---|
Severance Pay (Base Salary) | $2,500.00 | 16 | $40,000.00 | Lump Sum within 30 days | ||
Pro-Rated Annual Bonus | $5,000.00 | 0.75 | $3,750.00 | With final paycheck | ||
Accrued Vacation Payout | $3,846.00 | 1 | $3,846.00 | Standard payroll cycle | ||
$0.00 | ||||||
$0.00 | ||||||
$0.00 | ||||||
$0.00 | ||||||
$0.00 | ||||||
$0.00 | ||||||
$0.00 |
Is outplacement/career transition support being offered?
Are COBRA or equivalent health benefits continuation costs being subsidized by the company?
Does the separation agreement include a release of claims or waiver of rights?
I confirm that all severance calculations have been independently verified by Finance and align with approved budget provisions
Upload signed Severance Calculation Worksheets and Finance Approval Documentation
This section ensures comprehensive recovery of company assets, secure termination of system access, and establishment of post-employment obligations. Complete inventory verification and IT security protocols are critical.
Company Property & Asset Recovery Inventory
Asset Category | Asset ID/Serial Number | Asset Value | Returned | Return Date | Condition Upon Return | Cost to be Deducted | |
|---|---|---|---|---|---|---|---|
Laptop Computer | SN-ABC123456 | $1,800.00 | $0.00 | ||||
Mobile Phone | SN-DEF789012 | $800.00 | Yes | 7/1/2025 | Good | $0.00 | |
Security Access Card | ID-8847 | $25.00 | Yes | 7/1/2025 | N/A | $0.00 | |
$0.00 | |||||||
$0.00 | |||||||
$0.00 | |||||||
$0.00 | |||||||
$0.00 | |||||||
$0.00 | |||||||
$0.00 |
System Access Categories Requiring Revocation (select all applicable)
Network/Domain Access
Email & Collaboration Tools
CRM/Customer Databases
Financial Systems
HRIS/Payroll Systems
Source Code Repositories
Cloud Infrastructure (AWS/Azure)
Third-Party SaaS Applications
Physical Building Access
VPN/Remote Access
Does the employee have access to trade secrets or highly confidential information?
Target System Access Termination Date/Time
Is a non-disparagement clause included in the separation agreement?
Are post-termination restrictive covenants being enforced (non-compete, non-solicit)?
I confirm that IT Security has been notified and a ticket has been created for access revocation 24 hours prior to termination effective date
Upload Signed Asset Return Acknowledgment Form and IT Access Termination Confirmation
Final authorization requires joint certification from HR Business Partner and Chief Legal Officer (or designated legal counsel). Both parties must independently verify compliance, risk assessment, and documentation completeness before proceeding.
Compliance & Risk Assessment Matrix - Rate each domain (1 = Low Risk/Full Compliance, 5 = High Risk/Significant Gaps)
Selection Process Objectivity & Documentation | |
Disparate Impact Analysis Completeness | |
Severance Calculation Accuracy & Policy Adherence | |
Legal/Regulatory Obligation Fulfillment | |
Property Recovery & IT Security Protocol | |
Separation Agreement Legal Sufficiency |
Are there any identified compliance gaps or elevated legal risks requiring escalation?
Joint Approval & Certification Registry
Approver Role | Approver Name | Approver Employee ID | Review Completion Timestamp | I have independently reviewed all documentation and attest to compliance | I approve proceeding with this restructuring and severance arrangement | |
|---|---|---|---|---|---|---|
HR Business Partner | Alexandra Chen | EMP-HR-0082 | 7/15/2025, 2:30 PM | |||
Chief Legal Officer | Marcus Rodriguez | EMP-LEGAL-001 | 7/15/2025, 4:45 PM | |||
Final Summary Statement: Provide executive overview of restructuring scope, compliance confidence level, and any material issues requiring ongoing monitoring:
HR Business Partner Digital Signature
Chief Legal Officer Digital Signature
I acknowledge that this form and all supporting documentation will be retained in the employee's permanent record and may be subject to regulatory audit
Upload Final Signed Separation Agreements and all Supporting Compliance Documentation