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Clearance Form - Template PDF

This document is an employee separation checklist used to ensure an orderly transition when an employee leaves the company. It lists the steps to be completed in different departments like accounting, HR, and administration. These include turning over files and responsibilities, returning company property, settling financial matters, and completing an exit interview. Supervisors in each department sign off to confirm the tasks are finished. The completed form certifies that the departing employee has no outstanding accountabilities and is cleared to separate from the company.

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Zendy Pastoral
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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8K views2 pages

Clearance Form - Template PDF

This document is an employee separation checklist used to ensure an orderly transition when an employee leaves the company. It lists the steps to be completed in different departments like accounting, HR, and administration. These include turning over files and responsibilities, returning company property, settling financial matters, and completing an exit interview. Supervisors in each department sign off to confirm the tasks are finished. The completed form certifies that the departing employee has no outstanding accountabilities and is cleared to separate from the company.

Uploaded by

Zendy Pastoral
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Employee name: Date filed:

Position: Date hired:


Reason for separation: Date separated:

Dept Checklist (X) Remarks Signature / Date


Turnover of records/files (documentation)
DEPARTMENT

Turnover of pending activities/responsibilities


Completion of assigned responsibilities
Check contents of PC/laptop
Delete personal files in PC/laptop
Check area & pedestal for personal property
ACCOUNTING

Cash Advances
Loans
Liquidation
Loans
Reimbursements
Attach last pay computation
Return company issued property/equipment
(cellphone, laptop/PC set, etc)
Return ID
Return keys (for pedestal, etc)
Return HMO card
HR / ADMIN

Return business cards


Resignation letter
Delete access in Biometrics
Cancel access to email
Attach last attendance for the period
Contact information/forwarding address
Exit interview

This formally confirms that all Kittelson & Carpo Consulting documents, records and/or property in the
possession of Ms/Mr __________________________ have been returned and accounted for and that
she has completed the responsibilities that she is expected to perform prior her resignation on
______________________.

Clearance verified and certified complete:

Cheriza Sevilla Date signed


Finance and Admin Supervisor

A review of our records indicate that to the best of our knowledge, _____________________ has no
more accountabilities or pending responsibilities, and is therefore cleared of all or any accountabilities.

Approved by:

Derek Mernagh John Slyne

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