CLEARANCE CERTIFICATE

1. Name of the employee : MANOJ KUMAR MAGILI

2. Designation : PROGRAMME OFFICER

3. Location : DASAMANTPUR

4. Address for communication :At-Ramana Kupuli, Po-Kutragada

Ps-Muniguda, Dist-Rayagada
Pin code-765020

4a. Details of father’s employment with address and phone no. : Name : Shatrughana Magili
Occupation: Farmer
Contact no:9556686181

5. Date of joining with DHAN Foundation :1st October 2017

6. Date of resignation / termination submitted :10th June 2019

7. Last date of working : 30th June 2019

(Enclose your attendance register copy)

8. Reasons for leaving : resignation by employee

(end of contractual period / termination/
resignation by employee)

9. Handing over done to : Yes

Name : Handing over report

On (Date) : 30.06.2019
Report enclosed : Yes

Signature of the Staff: Verified by

Date:

Place:
 CLEARANCE CERTIFICATE from the Financial Responsibility Centre

1. Name of the employee : Manoj Kumar Magili

2. Location : Dasamantpur

3. Whether any amount is payable by the staff :No

on the date of leaving and arrangements
proposed by the FRC for recovery of the
dues:

 Personal advance :No

 Project advance :No

 Medical allowance advance :No

 Vehicle loan details :No

 Other advances to DHAN Foundation:No

Whether any amount is payable by DHAN Foundation to the concerned staff and steps proposed by
the FRC for timely payment.

 Salary :Yes one month Salary

 TA, LC :Yes

 Medical reimbursement claim :

 Others – please specify :

4. Whether vehicle used by the concerned staff is handed over to the new incumbent along with the
required documents. If No, please state the reasons:

Name of the FRC Leader / Accountant

Signature:

Date:

Place:
 Handing Over Certificate

This is to certify that Mr Manoj Kumar Magili, Programme Officer, Dasamantpur has settled all dues,

completed all the responsibilities and handed over full charge to Mr Bijaya Kumar Nayak Sr. Project

Executive on 30.07.2019. There is no objection to relieve him / her from our location / federation.

Handing over Charge to Handing over Charge from

Name & Signature Name & Signature

Name of the Programme Leader:

Signature:

Date:

Place:
 From Programme

This is to certify that Mr/Manoj Kumar Magili has settled all dues and responsibilities to Mr. Bijaya

Kumar Nayak He has submitted way forward report and handing over report to us.

There is no objection to relieve and settle his provident fund.

Recommended by Programme Leader (Name) :

Signature:

Date:

Place:
 From Centre for Human Resource Development

Checklist for relieving :

Received No Due certificates from :

Location / Region : Yes / No

Programme : Yes / No
DSDA : Yes / No/Not applicable
KDFS : Yes / No/Not applicable

Received a copy of :
Handing over report :
Way forward report :
Others if any :
Received ID card : Yes / No/Not issued

Received undertaking format from individual: Yes / No

This is certify that Mr/Ms…………………………………….. can be relieved from DHAN Foundation. There is
no objection to settle the PF to him / her.

Name of the Programme Leader (HRD):

Signature:
Date:
Place:
 Clearance Certificate from DSDA

This is to certify that there is no dues from Mr Manoj Kumar Magili as on 30 June 2019 there is no
objection to relieve him / her.

Name of the Treasurer / Secretary

Signature:

Date:

Place:
 Undertaking letter

I have worked in DHAN Foundation as Programme Officer at Dasamantpur from 1 st October 2017 to

30th June 2019 I have submitted my resignation letter to DHAN on 10 th June 2019 I believe that it is

under consideration of DHAN Foundation. I undertake to call on DHAN Foundation personally

whenever requested by DHAN Foundation after my relief in order to clarify any matters relating to the

work assigned to me, responsible and clarify any matters with specific reference to accounts handled

by me and audit report. I also undertake to comply with any of the duties assigned to me which I

have omitted to comply with at the time of the relief on request by DHAN Foundation.

Name : Manoj Kumar Magili

Signature :

Date : 30th July 2019