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It is issued in compliance with Section 1089 of the California Unemployment Insurance Code to ensure transparency and legal adherence. The form provides structured fields to capture essential information including employee demographics, position, department, and the effective date of the change. It covers various status transitions such as voluntary resignation, discharge or layoff, retirement, and leave of absence. The document includes dedicated sections for supervisory remarks, formal signatures, and distribution protocols, ensuring that both the employer and employee maintain a verifiable record of the employment status update. This template is designed for administrative and human resources departments to streamline the offboarding or status change process while meeting statutory reporting requirements. Its clear layout facilitates accurate record-keeping and regulatory compliance, providing a standardized approach for documenting the cessation or modification of the employer-employee bond effectively and professionally.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/notice-to-employee-as-to-change-in-relationship-2020-form/284592/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/notice-to-employee-as-to-change-in-relationship-2020-form/284592.png","ImageObject",442,249,{"name":88,"@type":89},"Angel","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-26","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":8},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the purpose of this document?","Question",{"text":108,"@type":109},"The document serves as an official notice to an employee regarding a change in their employment relationship, issued in compliance with Section 1089 of the California Unemployment Insurance Code.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What types of relationship changes are covered?",{"text":113,"@type":109},"The form covers voluntary resignation, discharge or layoff, retirement, and leaves of absence with a specified return date.",{"name":115,"@type":106,"acceptedAnswer":116},"Who needs to sign this form?",{"text":117,"@type":109},"The form requires signatures from both the employee and the supervisor to formalize the change in employment status.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},284592,1790177728,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":8,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},687207412472,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","NOTICE TO EMPLOYEE AS TO CHANGE IN RELATIONSHIP  \nName:   SSN:    \nPosition:   Department:    \nEffective Date (Month/Day/Year) :   Today’s Date (Month/Day/Year) :    \nIssued pursuant to provisions of Section 1089 of the California Unemployment Insurance Code  \nEMPLOYMENT RELATIONSHIP CHANGE  \n􀂈 Voluntary Resignation  \n􀂈 Discharge/Layoff  \n􀂈 Leave of Absence with Return Date of    \n􀂈 Retirement  \nRemarks and/or Reason:    \n| Employee’s Signature |\n| --- |\n| Supervisor (Print Name) |\n\n\n| Date (Month/Day/Year) |\n| --- |\n| Title |\n\nSupervisor’s Signature Date (Month/Day/Year)  \nDistribution: Original to Employee Personnel File, Copy to Employee","cbCaih35Q9Oara9Y","https://ap.wps.com/l/cbCaih35Q9Oara9Y","pdf",1237753,"English","# Employee and Position Details\n## Employment Relationship Change Options\n## Remarks and Signatures","[{\"question\":\"What is the purpose of this document?\",\"answer\":\"The document serves as an official notice to an employee regarding a change in their employment relationship, issued in compliance with Section 1089 of the California Unemployment Insurance Code.\"},{\"question\":\"What types of relationship changes are covered?\",\"answer\":\"The form covers voluntary resignation, discharge or layoff, retirement, and leaves of absence with a specified return date.\"},{\"question\":\"Who needs to sign this form?\",\"answer\":\"The form requires signatures from both the employee and the supervisor to formalize the change in employment status.\"}]","Notice to Employee as to Change in Relationship - 2020 - Form | PDF",1789628940]