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Clearance Form New

The document is a clearance form required for settling the final dues of an employee upon resignation. It includes sections for various departments to confirm the return of company property and to detail any recoverable or payable amounts. Employees must provide their contact information for future correspondence before final settlement of dues.

Uploaded by

Sourabh Tiwari
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35 views3 pages

Clearance Form New

The document is a clearance form required for settling the final dues of an employee upon resignation. It includes sections for various departments to confirm the return of company property and to detail any recoverable or payable amounts. Employees must provide their contact information for future correspondence before final settlement of dues.

Uploaded by

Sourabh Tiwari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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CLEARANCE FORM

Please note that the Final Dues of the employee will be settled
only after this form is completed.

NAME _________________ DESIGNATION _____________________

DEPARTMENT _________________ LOCATION ________________

JOINING DATE _________________ EMP. CODE ________________

RESIGNATION DATE _____________ RELIEVING DATE ___________

Address for future correspondence:

Email address:

Phone no._________________________________
Incase the contact details are not given by the employee at the time of leaving, the
same must be informed by the employees before the final settlement of the dues.
CLEARANCE FROM EMPLOYEE’S DEPARTMENT/
TO BE FILLED IN BY RM IN RO
ITEM HANDED OVER
(if not, please elaborate)
Files/Documents

Kit / Brochures / Directories/ price


list
Drawer keys

Mobile/SIM
Any other
(Please specify)

Superior’s / Div.Head Signature


Date
CLEARANCE FROM IT DEPARTMENT

ITEM HANDED OVER


(if not, please elaborate)
Laptop/Charger/Bag/Pen drive

Email id

Any other
(Please specify)

Superior’s / Div. Head Signature


Date

CLEARANCE FROM HRD DEPARTMENT


ITEM HANDED OVER
(if not, please elaborate)
Company Accommodation

Date of Resignation

Last date attended

Attendance Card
Attendance for current month
Days present
EL availed
SL availed
LWP
Total working days:
Recovery in lieu of shortfall of
notice period
Leave balance (earned leaves)

Any other
(Please specify)
HR Mgr/Dept Head Signature
Date

CLEARANCE FROM LOGISTICS


ITEM HANDED OVER
(if not, please elaborate)
Demo equipment

Company Vehicle

Any other

Supply Chain Mgr. Signature

CLEARANCE FROM ACCOUNTS DEPARTMENT


ITEM AMOUNT AMOUNT
RECOVERABLE PAYABLE
Tour Advance / Expense

Loans

Salary Advance

Medical Reimbursement

Leave Encashment.

Notice Pay

Incentives

Any other

(Please specify)
TOTAL AMOUNT
RECOVERABLE / PAYABLE
Accounts Head’s Signature

Date

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