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ExitClearanceForm

Note:ThisformwillbefilledbyPeople&signedoffbyclientaswell.PleasemarkN/Aifanyquestionsnot
applytoyouranswer.

ClientName:Employee#:

EmployeeName:DOJ:Designation:

Department:

Region:Location:

DateofResignationSubmission:LastWorkingDay:
dd/mm/yyyydd/mm/yyyy

NoticeperiodImmediateeffect

Ifnoticeperiodthen:Startdate:________________Enddate:________________
dd/mm/yyyydd/mm/yyyy

NoticeperiodServedDeductedWaiveOff

SurrenderPeoplepropertyincustody:IDCardGHICardOther

SurrenderClientpropertyincustody:________________________________________________________

ReasonforLeaving:________________________________________________________________________

__________________________________________________________________________________________

Permanentaddressoftheemployee(forcorrespondence):_______________________________________

_____________________________________________________Cell/HomePhone#:___________________

AnydeductionrequiredbyClient(pleaseprovidedetail):_____________________________________

Iherebydeclarethatthereisnoliabilitywhatsoeveronthisemployee.

SupervisorName(Client):__________________________________Designation:_____________________

Signature/Stamp:__________________________________________Date:___________________________

AnydeductionrequiredbyPeople(pleaseprovidedetail):___________________________________

__________________________________________________________________________________________

SupervisorName(People):_______________________________Designation:_____________________

Signature/Stamp:____________________________________Date:_______________________________

HRF08/V1.0/0809Confidential

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