FINAL PAY & BENEFITS CHECKLIST Complete for every separation. Final-pay timing and PTO payout rules vary by state — verify against current law for the employee's work state. Employee: [EMPLOYEE NAME] | Work state: [STATE] | Last day: [LAST DAY] Separation type: [ ] Resignation [ ] Termination [ ] Layoff [ ] Retirement Final pay calculation • Regular wages through last day: $ __________ • Overtime owed: $ __________ • Accrued unused vacation/PTO (per policy + state law): __________ hours = $ __________ • Earned bonus/commission owed: $ __________ • Allowable deductions (with written authorization where required): $ __________ • **Total final pay: $ __________** | Pay date: __________ | Method: [ ] Direct deposit [ ] Check Timing compliance • [STATE] deadline for this separation type: [e.g. Immediately / within 72 hours / next regular payday] • Deadline date: __________ — Met: [ ] Yes Benefits & notices • Benefits end date: __________ • COBRA / state continuation notice sent: [ ] Yes Date: __________ Method: __________ • Retirement plan distribution packet provided: [ ] Yes • Unemployment insurance notice provided (where required): [ ] Yes / [ ] N/A • HIPAA / privacy reminders given: [ ] Yes Records • Personnel file updated with separation paperwork: [ ] Yes • Payroll register reconciled: [ ] Yes Completed by: ___________________________ Date: ______________ Reviewed by: ___________________________ Date: ______________ --- General template only — not legal advice. Have employment counsel review before use, especially for state-specific requirements. Downloaded from AskHrAI (https://askhrai.com/forms/final-pay-checklist).