Employee Clearance Form
Name:
Designation:
Dept:
Joining Date:
Resignation Date:
Relieving Date:
CLEARANCE FROM DEPT HEAD
Sr. No. List of activities Status (Pending/ Completed)
Handing Over done to (Name):
Employee Signature: ____________________________________________ Date:__________
Signature of person to whom handing over was done: __________________ Date: _________
Signature of Departmental Head: __________________________________ Date: __________
CLEARANCE FROM IT
Sr. No List of items Status (Returned/ Not returned)
1.
Assets (S/W, H/W, manuals,Laptop) handled by employee
2.
ERP/CRM Access Disabled
3.
Mail Access Disabled
4.
Internet Access Disabled
Other Applications Disabled
Signature (IT): ______________________ Date:
CLEARANCE FROM FINANCE
Sr. No Item Name Remarks Signature
1 Loans/Advance
2 Travel Advance
Signatures: (Finance)_________________ Date: __________________
CLEARANCE FROM HR
Sr. No. List of items Status (Returned/ Not returned)
1.
Access Card Tokens Handed Over: ____
2.
Keys Handed Over: ____
3.
Identity Cards
4.
Other Accesses
5..
Mobil
CLEARANCE FROM HR (to be given only after obtaining all the above clearances and completion of
exit interview)
Signature: (HR) ______________________ Date: __________________
Address for further Correspondence: