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Exit Clearance Form - DSIL

An employee clearance form documents an employee's resignation details like name, designation, department, joining date, and resignation/relieving dates. It requires signatures from various departments like IT, Administration, Finance, and HR to confirm the returning of company assets and clearance of dues. Signatures are needed to verify the return of items such as software, hardware, login credentials, access cards, laptops, identity cards, keys, mobile phones, books, and confirmation of final settlement before HR clearance.

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Ramesh Sabat
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1K views2 pages

Exit Clearance Form - DSIL

An employee clearance form documents an employee's resignation details like name, designation, department, joining date, and resignation/relieving dates. It requires signatures from various departments like IT, Administration, Finance, and HR to confirm the returning of company assets and clearance of dues. Signatures are needed to verify the return of items such as software, hardware, login credentials, access cards, laptops, identity cards, keys, mobile phones, books, and confirmation of final settlement before HR clearance.

Uploaded by

Ramesh Sabat
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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Employee Clearance Form – Resignation

Name:
Designation:
Dept:
Joining Date:
Resignation Date:
Relieving Date:
The following authorities of each department shall make sure and sign
that employee has already returned everything that belongs to each
department.
Department / Office Employee Authority
IT Department
Assets - S/W, H/W
Login Id / E-mail ID
Access card
Laptop/Internet Access
Any other Company Assets Signature: Signature:
CUG No. Date: Date:
Administration Dept
Identity-cum-Attendance Card
Card Holder /Drawer Keys/ Transport dues
Cell phone
Lunch dues Signature: Signature:
Books Date: Date:
Finance Dept Signature:
Confirmation of full & final settlement / Corporate Card [Y/N] / If Date:
Yes, Clearance
Loans/Advance Signature:
Travel advance Date:
HR Dept Signature:
CLEARANCE FROM HR (to be given only after obtaining all the Date:
above clearances and completion of exit interview) Signature:
Date:
Address for further Correspondence:
Signature of HR_______________________ Date ______________

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