Acme Manufacturing · My documents

Rae Donnelly

Fresno Distribution Center · CA

Everything you have signed or been given, kept as you received it. These copies do not change when a form is later updated — what you signed is what you see.

Documents I signed — the exact version you signed, frozen

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Pamphlets and notices I was given — required notices provided to you

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Safety plans I acknowledged — the written plan for your worksite, as you acknowledged it

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Leaving documents — your final paperwork — yours to keep

HIPP "Notice to Terminating Employees" (DHCS 9061)Official form

Received 2026-09-20

CA — DHCS · version DHCS 9061 · signed as Rae Donnelly

Federal COBRA Model Election NoticeOfficial form

Received 2026-09-20

FED — DOL / EBSA · version DOL model · signed as Rae Donnelly

Final Itemized Wage Statement

Received 2026-09-20

Employer payroll · version v1 · signed as Rae Donnelly

Notice to Employee as to Change in Relationship

Received 2026-09-20

CA — EDD (sample) · version v1 · signed as Rae Donnelly

"For Your Benefit" — California's Programs for the Unemployed (DE 2320)Official form

Received 2026-09-20

CA — EDD · version DE 2320 Rev. 2026 · signed as Rae Donnelly

COBRA / Cal-COBRA Election Form

Signed 2026-09-20

FED — plan administrator / carrier · version v1 · signed as Rae Donnelly

Reference & Verification Release Authorization

Signed 2026-09-20

EHM template · version v1 · signed as Rae Donnelly

Exit Interview

Signed 2026-09-20

EHM template · version v1 · signed as Rae Donnelly

Return of Company Property — Receipt

Signed 2026-09-20

EHM template · version v1 · signed as Rae Donnelly

Final Pay Summary & Acknowledgment

Signed 2026-09-20

EHM template · version v1 · signed as Rae Donnelly

My certificates — issued when you complete a training

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This library is permanent and keeps filling: anything you sign later — an annual re-acknowledgment, separation paperwork — lands here too. Back to my home