CLEARANCE FORM

Seal Infotech Pvt. Ltd

Name : Designation : Department : Date of Resignation : Employee No. : Date of Joining : Team /Assignment: Date of Release : .

________________________ is being relieved with the closing hours of ______________ Please fill the details in this form to enable us to process the papers at the earliest. Clearance From Items Remarks / Recovery Amount

Signature & Name

Department Head/ Reporting Manager

Manuals/Tapes/Diskettes handed over Knowledge transition done Completed the Performance appraisal/ feedback for juniors

Networking & System Support (IS) Administration

Terminal/Key Board/Mouse/Internet and E-mail id / LAN id / Diskettes Drawer/ storage keys/Stationery items Personal Telephone Calls (ISD/STD) Identity Card and name plate Other dues, if any Air - Tickets Other dues, if any

Human Resources

Exit Interview done by Leave Encashment Recovery for excess leave Other dues, if any

Accounts

Advances / Loans Onsite Travel Advance Medical reimbursement / Bonus Taxes Other dues, if any:

P.T.O.

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CLEARANCE FORM

Seal Infotech Pvt. Ltd

Notice Period Details : Notice Period to Serve
Notice Period Served Shortfall in Notice Period Shortfall in Notice Period to be adjusted against leave balance Shortfall in Notice Period to be waived

YES / NO YES / NO

Leave Details : Updated Leave records : Current Leave Balance: Total leaves available
Leaves to be encashed: Recovery against excess leaves:

Yes /

No

Remarks by HR:

Declarations by the Employee: 1. I wish the following action to be taken in respect of my PF: Withdraw Transfer
Please fill up the PF account withdrawal form available with Finance dept. Withdrawal usually takes 4-6 months. Please fill up the PF account transfer form available with Finance dept. Transfer usually takes 3-5 months.

2. The following amounts are due against my name:

3. My contact Address, Telephone number & E-mail Id for future correspondence regarding any remittances, etc. :

4. I agree to reimburse the total amount against my personal bills that may be received by the company after my relieving.

Employees Signature Date

Approved by Human Resources Date

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