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IT, web, Internet, software, hardware, media, multimedia, photography, tech, information, technology, computer, business, company, pre-written, legal, contract, agreement, documents, templates, boilerplate, form, outline, text, terms, recitals hr Company Termination Domestic Partnership CurrentDate Employee Name ContractFirstName ContractLastName Employee SSN SSN Partner Name Insert Partners First Name Insert Partners Last Name Partner SSN Partner Social Security Number Department Department Supervisor Supervisor Instructions Please complete the following form signing both employee and partner names each line and return the Human Resources Department NOTE This Termination Domestic Partnership Statement may affect any current coverage for your Domestic Partner and the rates you pay under any Company Insurance Plans Company sponsored benefits hereby declare that former Partner please print and are longer Domestic Partners and our Domestic Partnership ended Employee Signature Date Partner Signature Date Human Resources Representative Date Address1 Address2 City State PostalCode Phone WorkPhone
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