5.clearance Certificate

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Clearance / Recovery Certificate

1. Employee Name: 6. Employee ID:


2. Department: 7. Designation:
3. Date of Joining: 8. Resignation:
4. Location: 9. Reporting Manager:
5. Last working day

PLEASE TICK a WHERE APPROPRIATE

Particular (Employee) Yes No NA Remarks


Employee has completed the handover and transition of work
Employee system backup is verified
Leave submitted in the system up-to the LWD
Employee has filled in the timesheet and is reviewed
Employee has returned his/her uniform

Particular (IT) Yes No NA Remarks


Employee has returned Laptop/Desktop and Mobile Phone and all accessories issued
(Adopter with power cord, Extra battery, Pen Drive, Data card, CD’s, Laptop Bag),
related to this strikeout whichever is not applicable
If any repair work is required on laptop/desktop then please write in remarks.
In case of repair; the approval of reporting manager required or not
Employee mail ID, Telephone and all network access has been disabled
Employee system back-up has been taken and shared with manager
IT Dues If Any (in INR) Amount:

Particular (Administration) Yes No NA Remarks


Medical Insurance Card Returned
Medical Insurance company notified
Insurance mediclaim pending settlement before insurance company (Yes/No) and
status thereof
Fingerprint (biometric access) disabled
Workstation/cabin is cleared from paperwork and handover to manager
Building access card returned (if applicable)
Parking access card returned (if applicable)
Office doors and cubicles keys returned (if applicable)
Filling cabinet keys/Desk drawer and other logistics(calculator if applicable) returned
Corporate credit card handed over/blocked permanently
Petty cash settlement – applicable to designated holders of petty cash(if applicable)
Admin Dues (in INR) Amount:

Particular(Finance) Yes No NA Remarks


Employee has submitted all expense claim documents and has no dues (Approval
Mandatory)
Employee has no outstanding loan and advance due
Petty cash settlement – applicable to designated holders of petty cash (if applicable)
Income tax rebate/relief (section 80C, 80D, etc) related supporting have been
submitted
Clearance / Recovery Certificate
Income/loss from house property computation along with supporting documents have
been submitted
Provident fund withdrawal / transfer documents received
Corporate credit card handed over/blocked permanently(if applicable)
Online banking credentials disabled/handed over (applicable in case of finance
department)
Finance Dues (in INR) Amount:

Particular (Human Resource) Yes No NA Remarks


Medical insurance company notified
Leave and other exit details updated, approved and matching in ERP & HRMS
Conducted Exit Interview
All outstanding loan considered for settlement
Intimate the exit to bank and get a confirmation on any dues
Number of days to be recovered as NOTICE PERIOD (to be approved by Reporting
Manager or HOD as the case may be)
HR Dues (in INR) Amount:

Particular (Stores) Yes No NA Remarks


Watches (if part of uniform) have been returned
Physical reconciliation of stock has been done and no discrepancies has been found
Watches sent to service centers for repairing have been accounted for as per the
attached list (only applicable for service technician)
Store Dues (in INR) Amount:

Department Date Sign


HOD DD-MM-YYY

Reporting Manager DD-MM-YYY

IT Head DD-MM-YYY

Administration DD-MM-YYY

HR Head DD-MM-YYY

Finance Head DD-MM-YYY

Employee DD-MM-YYY

Note: Full and Final Settlement shall be processed within 90 days’ of receiving the duly signed
“Clearance/Recovery Certificate”

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