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F & F Clearance Form

This document is a clearance form for an employee leaving M/s PP Merchandising Services Pvt Ltd. It summarizes amounts due to/from the employee across various departments. It details the handover of equipment, documents and access permissions from the concerned department. It also provides the employee's salary details, leaves, benefits and adjustments for settlement. The total amount payable or due from the employee is calculated and approved. The employee signs declaring the details on the form are correct.

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Naveen Kumar
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205 views1 page

F & F Clearance Form

This document is a clearance form for an employee leaving M/s PP Merchandising Services Pvt Ltd. It summarizes amounts due to/from the employee across various departments. It details the handover of equipment, documents and access permissions from the concerned department. It also provides the employee's salary details, leaves, benefits and adjustments for settlement. The total amount payable or due from the employee is calculated and approved. The employee signs declaring the details on the form are correct.

Uploaded by

Naveen Kumar
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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M/s PP Merchandising Services Pvt Ltd

CLEARANCE FORM BY AN EMPLOYEE ON HIS CESSATION OF EMPLOYMENT

To, Emp.Code ;_________________ From,


Human Resources Location :_________________
Department. Date Of.Joining :_____________ Name :________________________________________
Department : _______________ Contact Address:
Reporting to :_______________ Tel / Mo.No: ___________________________________
D.O.R.: ________________ Personal E-Mail ID: _____________________________

CONCERNED BRANCH/DEPARTMENT (A) REMARK AMOUNT DUE TO EMPLOYEE


I confirm that I have received the keys to the Due to Employee
drawer/ locker/tools,kits, cabinets,and office Unpaid Rs. ________________
permises.I have taken over all the stationary Any other Payable Rs.___________________
like staplers, calculators punching machines
books/periodicals that may be with him/her. Due from the Employee
All the documents like indentity card files, Rs.______________________
customer contacts,visiting cards Rs.______________________
.ect.have been handed over to me .
I have passwards to the various files/floppies Sign of Reporting Officer Tatal (A) _____________________
and access driver.
ADMINISTRATION FUNCTION (B) REMARK AMOUNT DUE TO/FROM EMPLOYEE

Rs.___________________________________________

I confirm that I have received the Laptop, mobile hansets,


Sim Cards and all other tools/equipments of the Company TOTAL (B).____________________________________
that was provided to him/her Sign of Reporting Officer
HR DEPT. ( C )
Number of days worked in the month __________ Last working day_________ On Leave Account Rs. ____________
Leave Balance PL: ______ Days Notice period A/C RS.____________
Adjustment ( if any ) of days for the notice period _______________________ Leave Encashment
Basic + D.A. on relieving date :______________________________________ Payable - Taxable _____________________
Average pay :_____________________ Payable - Exempt _____________________
Completed Years of Service :-_______________________________________ Gratuity
Gratuity ( if applicable ) :________________________ Payable ______________________________
Bonus
Payable ______________________________

Signature of HR Head Total ( C ) ____________________________


ACCOUNTS/OPERATIONS FUNCTION (D)
Outatanding Advances Rs._____ ___________________
Imprest Recovery Rs.________ _______________
Any other adjustments Rs.______________________
Total due from Employee Rs._________________________
I have ensured that the appropriate authorities have been informed for removing his name from Authorised Signatory list and
any Power of Attorney / latter of Authorisation ( if Applicable).

Signature of Accounts Head Date


OTHER BENEFITS DUE FOR SETTLEMENT ( E )
Salary kept on hold / excess paid for _______________________ month Rs._________________________
Any other adjustment. Rs._________________________
Total (F) ____________________

Payable :
Leave Encashment ( From C) Rs._________________________
Gratuity ( From C ) Rs._________________________
Concerned Department & HR ( From A & B ) Rs._________________________
Account Function ( From D ) Rs.___ ____________________
Others ( From F ) Rs._________________________
Any others (From E Rs._________________________
Total due to/Due from Employee ( in figures ) Rs._________________________
( In Words.

Human Resources / Personnel Administration Department. Approved By


Declaration of Employee
I have carefully gone though the above details and found to be correct.

Signature of the Employee

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