Thanks to visit codestin.com
Credit goes to www.scribd.com

Scribd
Upload
1K views2 pages

Employee Exit Clearance Form

This document is a clearance form to be completed by an employee before leaving a company. It lists various departments and details that need clearance, including business unit, administration, IT, CFO, HR, stores. The employee must get signatures under each department certifying clearance before their last working day. Incomplete forms will not be accepted. The form collects essential details of the departing employee like date of resignation, business title, contact details and clearance status from different departments.

Uploaded by

Tafadzwa Edson Pasi
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
1K views2 pages

Employee Exit Clearance Form

This document is a clearance form to be completed by an employee before leaving a company. It lists various departments and details that need clearance, including business unit, administration, IT, CFO, HR, stores. The employee must get signatures under each department certifying clearance before their last working day. Incomplete forms will not be accepted. The form collects essential details of the departing employee like date of resignation, business title, contact details and clearance status from different departments.

Uploaded by

Tafadzwa Edson Pasi
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
You are on page 1/ 2

CLEARANCE FORM

(To be completed before Leaving)

Mr./ Mrs./ Ms.: UPI Code :

Date of Resignation : Date of Leaving :

Business Unit: Date of Joining :

Business Title : Location :

Email id: Tel No.

Address For Future Communication :

S.No Clearance Details Clearance Name of Signature


By: the
Employe
e
BU / Functional Head
1 Business Unit Head’s clearance for Business Unit    
relieving. Head
2 Exit Interview Form Supervisor    
3 All official documents/CDs/Process Supervisor    
handed over
4 Personal Disk space cleared on Supervisor    
Computers.
Remarks :

Administration Department

5 Employee ID Card/Access Card Admin    


6 Drawers cleared and keys returned Admin    
7 Mobile handset and Sims Cards Admin    
8 Data Card Admin    
9 Balance Visiting Cards Admin    
10 Telephone connection (if any) Admin    
Remarks Admin :

IT Department

11 Lap Top / Desktop and Accessories Local IT    


12 Authorization Code for STD/ISD Local IT    
13 Deactivation from Mailing List Local IT
14 Calling Cards Local IT    
Remarks IT Department :

CFO
15 Loans / Deposits CFO    
16 Company credit card CFO  
17 Settlement of all dues CFO    
18 Submission of all expense vouchers CFO    
due.

Remarks by CFO :

HR

19 Intimation for deactivation of access HR Person    


card
20 Acceptance Letter subject to HR Person    
clearance of dues.
21 Balance leave status HR Person ________  
days;
22 Notice period to be recovered HR Person ________  
days;
Remarks by HR :
HR Team :
Termination of record in software if HRSC Team
23 any    

Stores

Equipment (if any) Store in


24 charge    

Note: * This form should be returned to HR- Department, on or before the last working
day

**Please do not keep any of the field empty, as incomplete form will not be
entertained

***Some of the fields may not be applicable to all, in such case please mention N/A

**** Please submit the balance reimbursement and Income Tax proof documents
along with the clearance form

Employee Signature: __________________________


Date : _________________________________

You might also like