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    Employment Clearance Form - Revised

    Uploaded by

    Al Pineda
    This document is an employment clearance form for an employee named Rohith Pandicherry who resigned from his position as a rental sales agent. The form is used to ensure all company property is returned before the last day of work and to note any deductions needed from the employee's final pay. Sections are included to be signed by various departments to confirm the return of items like files, keys, company vehicles, equipment, and that there are no outstanding debts to the company.

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    © All Rights Reserved
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    Employment Clearance Form - Revised

    Uploaded by

    Al Pineda
    20 views8 pages
    This document is an employment clearance form for an employee named Rohith Pandicherry who resigned from his position as a rental sales agent. The form is used to ensure all company property is returned before the last day of work and to note any deductions needed from the employee's final pay. Sections are included to be signed by various departments to confirm the return of items like files, keys, company vehicles, equipment, and that there are no outstanding debts to the company.

    Original Title

    Employment Clearance Form.revised

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    This document is an employment clearance form for an employee named Rohith Pandicherry who resigned from his position as a rental sales agent. The form is used to ensure all company property is returned before the last day of work and to note any deductions needed from the employee's final pay. Sections are included to be signed by various departments to confirm the return of items like files, keys, company vehicles, equipment, and that there are no outstanding debts to the company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    20 views8 pages

    Employment Clearance Form - Revised

    Uploaded by

    Al Pineda
    This document is an employment clearance form for an employee named Rohith Pandicherry who resigned from his position as a rental sales agent. The form is used to ensure all company property is returned before the last day of work and to note any deductions needed from the employee's final pay. Sections are included to be signed by various departments to confirm the return of items like files, keys, company vehicles, equipment, and that there are no outstanding debts to the company.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    You are on page 1of 8

    EMPLOYMENT CLEARANCE FORM

    Employee Information
    Name: ROHITH PANDICHERRY
    Emp. Code: ______3429________________
    Designation: __RENTAL SALES AGENT ______________ Department: ____D20 - DEPARTURE_____
    Reporting Mngr.: __K.P.Suresh_____________________ Location: ________D18_________________
    Joining date: ___29-03-2011________________________ Last working date: __23-11-2012________
    Remarks:___Resigned_____________________________
    Mobile No.:___055-6470564 __________

    Resigned & terminated employees are required to surrender all company property given for fulfillment of
    job. All of these shall be returned to respective Departments before the last working date & authorize
    signature shall be affix in this form as acknowledgement of complete return. This shall contain also
    necessary deductions need to be made against the employee, justification should be attached.

    Please check appropriate boxes, kindly specify other items surrendered or necessary
    description.
    1. Employees Department: ____________________________
    a) Related files- password/ soft copies __________N/A________________
    b) Telephone & supplies e.g. stapler, scissors, stationeries, etc. _________N/A____________
    c) Company car/ car keys with VDR ___N/A________

    e) Petrol Card ______N/A____________

    d) Cabin/ office/ drawer/ file keys_____N/A________

    f) Cheque books _______N/A_______

    g) Other things as applicable___________N/A__________________


    Outstanding item: _______NIL________________
    ___________________________

    Amount to charge:

    Cleared by: __NASIRUDEEN


    2012____________

    _________(Name & Signature) Date: ____27-11-

    2. IT Department
    a) PC set/ laptop ______________________
    b) E-mail ID

    ______________________

    c) Personal printers, fax machine_______________


    d) CDs, DVD, USB etc._________________________

    Outstanding item: _______________________


    Amount to charge:
    ___________________________
    Cleared by: _____________________________(Name & Signature) Date: ___________________________

    3. Accounts Department
    a) Salary Advance______________________________

    b) Petty Cash_______________________________

    c) Traffic Fine __________________________________

    d) Telephone charges_______________________

    e) Personal Company Loan (if given)_____________

    f) Vehicle Hiring charges ___________________

    Outstanding item: _______________________


    Amount to charge:
    _________________________
    Cleared by: _____________________________ (Name & Signature) Date: __________________________

    4. Human Resources Department


    a) Company ID _________________________________

    b) Labour Card & Insurance Card (for visa cancellation) __________________________________


    c) Family Insurance Card (if issued) _____________
    d) GSM Chip or/ and mobile phone_____________
    e) Uniform deduction __________________________
    f)

    Recruitment cost

    __________________________

    g) Library books/ materials______________________


    h) Bank Loan details ___________________________

    Account No._________________________

    Outstanding item: _______________________________


    Amount to charge: _________________
    Cleared by: _____________________________________(Name & Signature) Date: _______________

    Remarks:
    __________________________________________________________________________________________
    Note:

    This document will be attached in the request of HRD for your FINAL SETTLEMENT; any dues will be charge to your
    final pay.
    Incase the space provided above is not sufficient to list other items; an additional separate paper can be
    attached.

    QR/HR/ECF/009: Issue Status:01

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