No Objection Certificate

Name of the Employee :

Employee Code :
Department & Designation :
Organization :
Date of Resignation :
Requested date of relieving :
Branch :
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Please prepare no objection certificate after scrutinizing all records and registers. All the future liabilities by the
resigned employee will be the responsibility of the concerned signatories.
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Department Head

Sl. No Particulars Remarks

1 Duties and responsibilities handed over

2 Files, records, registers and stationery handed over

3 Pending works or issues if any

4 Collection of Identity card & Mediclaim card if issued.

5 Mention the number of days Notice Served

6 Leave Summary to Date

7 Travel, Salary or other advances paid from petty cash or otherwise, if any.

Handing over the petty cash related details like files & bills to whom (Specify the name &
8
Emp code)

9 Specify the petty cash balance amount & Date

10 Any NCFM certificate to be handed over

11 Stamp Paper

12 The employee can be relieved from the service of the organization

HOD

Compliance Department
Remarks
Sl. No Particulars

1 NCFM Deactivation

2 Pending Issues If Any

3 The Employee can be relieved from the organization

 HOD

Depository Department
Remarks
Sl. No Particulars

1 Pending Issues If Any

2 The Employee can be relieved from the organization

HOD

Accounts Department
Remarks
Sl. No Particulars

1 Salary advance if any

2 Travel advance

3 Personal Loans

4 Pending issues if any

5 The employee can be relieved from the service of the organization

HOD

Administration Department

Sl. No Particulars Remarks

1 Collection of stationery, Mobile Phone, Visiting cards, Computers etc

2 Whether availing company provided accommodation

3 Pending Issues If Any

4 The employee can be relieved from the service of the organization

HOD
 Technical Department
Remarks
Sl. No Particulars

1 Mail id & other computer access blocked

2 Collection of Laptop, Data card, Pen drive & Computers etc

4 Pending Issues If Any

2 The Employee can be relieved from the organization

HOD

Human Resource Department

Sl. No Particulars Remarks

1 Collection of Identity card

2 Updation of leaves

3 Whether Transfer of email id completed

4 Any NCFM certificate to be handed over

5 Collection of Mediclaim Card if issued

7 Salary Advance if any

18 Pending Issues If Any

9 The Employee can be relieved from the organization

HOD