Employee Clearance Form

Terminated/Resigned employees shall return Company property to a supervisor or Human

Resources staff. Any work-related documents or files must remain the property of the company.
Failure to return Company property may result in legal action to recover such property.

Name: Date:
Employee ID# Last Day on Duty:
Please provide home e-mail address/cellphone number/mailing address:

Additional Information or comments:

The following Property has been returned to

Quantity Item

Employee Name Signature /

Date

Supervisor name Signature / Date

HR Staff Signature / Date

Head Management Signature / Date