CLEARANCE FORM

NAME EMP CODE

DESIGNATION DEPARTMENT
LOCATION DATE OF RESIGNATION
DATE OF JOINING LAST WORKING DAY
DEPARTMENT LIST OF DOCUMENTS STATUS DUES (IN RS.) NAME & SIGN
Pending Job Handover/
Responsibilities
Competitor Database
JOB/WORK/ Student Database
BRANCH RELATED Files/Records
HANDOVER Debit Card with Pin No.
Drawer/Locker/Branch Keys
General Administration
Visiting Cards if issued
Cash / Cheque if any
ACCOUNTS
Loan or Imprest Clearance
Expense Claim from ___________
to ____________
MARKETING Expense Claim Submitted to A/C
Dept
Executive Bag

DLP Fee Receipt Book/PMR

Laptop (with Serial No.) & *If so please describe the
Charger damage and provide recovery
Mobile Handset (with Serial No.) amount

& Charger
IT
(SBN & ERP) Sim Card & Mobile No.
Data Card (with Serial No.)
Official No. Block (Y/N)
LMS/Branch Email ID if issued
ERP ID if issued
ID Card
Email ID
HR & HRIS
HRIS (Separation/Reporting
Changes/Pending Intimations)
ITUTOR iTutor, SD Card & Accessories

I _______________________ hereby declare that I authorise company to NEFT F&F amount in my bank account
and I have returned all Company property/assets to my Branch Manager /Company authrozied person
Signature of Employee:- _____________________________ Date:- ______________________
Address: _______________________________________________________________________________
Personal EMail ID: ___________________________________ Personal Phn No.____________________
Signature of Reporting Authority:- _____________________ Signature of HR:____________________