Vendor Exit / Offboarding Request Form

✓ Section A: Basic Information

A1. Requestor name:

A2. Department:

A3. Date:

A4. Vendor name:

A5. Contract number (if known):

✓ Section B: Exit Details

B1. Reason for exit (select all that apply):

Contract expiration / non-renewal

Vendor replacement

Service no longer needed

Performance issues

Cost reduction

Security/compliance concerns

Vendor going out of business

Other (describe below)

B2. Contract end date:

B3. Desired exit completion date:

B4. Has formal termination notice been provided to vendor?

Yes

No

B5. Is there a replacement vendor?

Yes

No - Service being discontinued

No - Bringing in-house

✓ Section C: Data Disposition

C1. Preferred data disposition:

Return all data to us

Securely destroy all data

Return copy and destroy original

No company data held

C2. Required data format for return (if applicable):

CSV

JSON

Database export (specify below)

Original format

Other (describe below)

C3. Certificate of destruction required?

Yes

No

✓ Section D: Access & Transition

D1. Target date for access revocation:

D2. Are there physical access badges or tokens to retrieve?

Yes

No

D3. Knowledge transfer required?

Yes

No

D4. Knowledge transfer recipient (if applicable):

D5. Is there service continuity risk during transition?

Yes

No

✓ Section E: Financial & Legal

E1. Outstanding invoices, payments, or disputes?

Yes

No

E2. Has Legal been notified?

Yes

No - notification required

✓ Section F: Additional Information

F1. Special considerations or concerns:

F2. Lessons learned / feedback about this vendor:

✓ Section G: Attestation

I confirm this vendor offboarding is authorized.

Signature:

Date: