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Clearance Form.

This document is a clearance checklist for an employee, Mr. SEKH, leaving his job as a Footwear Advisor at a retail store in South City Mall in Kolkata. [1] It details the processes that must be completed regarding his exit including stopping his salary, recovering the notice period he did not serve, updating employee records, returning company property, and completing financial processes like paying out bonuses, recovering advances, and submitting tax documents. [2] Signatures from various departments like HR, Accounts, IT, Administration, and his Reporting Manager are required to confirm completion of the exit checklist. [3] Personal information is also collected from Mr. SEKH like his address and bank details for final settlement payments.

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Imc Ayurved
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1K views2 pages

Clearance Form.

This document is a clearance checklist for an employee, Mr. SEKH, leaving his job as a Footwear Advisor at a retail store in South City Mall in Kolkata. [1] It details the processes that must be completed regarding his exit including stopping his salary, recovering the notice period he did not serve, updating employee records, returning company property, and completing financial processes like paying out bonuses, recovering advances, and submitting tax documents. [2] Signatures from various departments like HR, Accounts, IT, Administration, and his Reporting Manager are required to confirm completion of the exit checklist. [3] Personal information is also collected from Mr. SEKH like his address and bank details for final settlement payments.

Uploaded by

Imc Ayurved
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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HR/ Exit / 2017-18

Clearance Checklist Form

To be filled
Employee by office staff
Name: only: FAIM
Mr. SEKH Employee code 0240
Reason of Exit: Resignation Absconding Retirement Termination Natural calamities
Designation: FOOTWEAR ADVISOR Date of Joining: 27-03-2017

Branch/ Location: SOUTH CITY MALL ( KOLKATA) Date of Resignation: 03-02-2018


1. Human Resource Department Signature Remarks
Department: RETAIL SALES To be Relieved by: 19-02-2018
1.1 Salary to be stopped (w.e.f) Date: 19-02-2018

1.2 Notice period to be served as per


Days 30
Appointment Letter
1.2.1 Notice period actually served Days: 15

1.2.2 Shortfall of Notice period Days: 15


1.2.3 Whether notice period waive off
Days: NO
( If yes, attach the partner approval)
1.2.4 Notice period to be recovered Days: 15

1.2.5 Current Leave Balance Days: 7

1.2.6 Separation info. to HDFC  Yes  Not applicable

1.2.7 Exit Interview  Yes

1.2.8 Separation Info. updated in HRIS  Yes  Not applicable


1.2.9 Separation Info. updated in Attendance
 Yes  Not applicable
sheets and Finger impression software
1.2.10. Separation Info. Updated in B’day D.B.  Yes  Not applicable

1.2.11. Provident Fund Withdrawal / Transfer  Yes  Not applicable

1.2.12. Gratuity Benefits Formalities  Yes  Not applicable

1.2.13.Submission of Mediclaim / Cashless card  Yes  Not applicable


1.2.14. Separation info to the Insurance
 Yes  Not applicable
Company

2. Accounts Department: Signature Remarks

2.1 One time Bonus  Yes  Not applicable


2.2 Any recoverable
 Yes  Not applicable
(Advances or loans taken from the firm)
2.3 Submission of - Proof of tax savings  Yes  Not applicable

2.4 Statement/s of conveyance  Yes  Not applicable


Note* All amounts processed through Full and Final Settlement are subject to tax deduction at source.
Hence, kindly submit your proof of tax savings along with your clearance form.

3. Administration Department: Signature Remarks

3.1 Submission of ID card / Swipe card  Yes  Not applicable

3.2 Submission of Mobile  Yes  Not applicable

3.3 Submission of Drawer Keys  Yes  Not applicable

3.4 Submission of Stationary items  Yes  Not applicable

Page 1
HR/ Exit / 2017-18

4. IT Department Signature Remarks


4.1 Laptop submission  Yes  Not applicable
4.2 Pen Drive  Yes  Not applicable
4.3 Data Card  Yes  Not applicable

5. Reporting Manager Signature Remarks


5.1 Submission and handover of all files and
 Yes  Not applicable
related documents
5.2 Completion of all current assigned projects  Yes  Not applicable
5.3 Submission of Passwords
(Documents, Email id, PC)
5.4 Date on which deactivation of Email _ID is
 Immediate  Date:
to be done
5.5 If email forwarding is required, then please
specify to which email id

Note* Separated employee cannot access his/her mailbox.

To be filled in by Employee
Address For Correspondence (Mandatory) -

Contact Numbers Mobile No: Residence No:

Personal Email – ID:

Bank Name & Branch Name (Salary Account):

Bank account no.:

Employee: HR – representative:
Signature Signature
Name Name
Date Date

Page 2

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