EMPLOYEE EXIT AND CLEARNACE

Part A: Exit Questionnaire

Name: _______________________________ File #: ______________________________

Department:__________________________Job Title: _____________________________

Date of Leaving: _______________________

(Please indicate reason, which applies to your situation.)

1. What are your primary reasons for leaving?

Relocation Family/personal needs Retirement

Further Education Heath Issues Pay Dissatisfaction

Lack of recognition of work working environment Quality of Supervision

Lack of advancement opportunities Work-hours Benefit Dissatisfaction

Discontinuation of funding Workload Non-renewal of contract

Other ___________________________________________________________

2. What did you find most satisfying about your job?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

3. What did you find most frustrating about your job?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

4. Were there any PITB policies or procedures that made your work more difficult?
______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________
 EMPLOYEE EXIT AND CLEARNACE
5. Would you consider returning to PITB in the future?
_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

6. Would you recommend PITB to a friend as a good place to work?

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

7. Is there anything PITB could have done to prevent you from leaving?
_______________________________________________________________________________

_______________________________________________________________________________

8. Additional Comments:

Thank you for your cooperation.

Employee
 EMPLOYEE EXIT AND CLEARNACE

Part B: Handling / Taking Over

EMPLOYEE

Employee Name: __________________

File #: _______________________

Department: ______________________ Designation: ____________________

Date of Leaving: __________________

SUCCESSOR

Successor Name: __________________ File #: _________________________

Department: ____________________ Designation: _____________________

It is hereby certified that a formal Handing-Taking over has been completed by the employee
and successor. All documents and necessary data pertaining to the job responsibilities have
been handed over by the employee and the successor.

Job Responsibility:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Handed Over to: ________________________ File#: ______________________________

Soft and Hard Copies of the Following have been handed over to the successor:

1. Detailed documentation of all existing process.

2. A list of all reports/ project concept papers/ presentations/ PCIs/ contracts/ manuals/
SRS/ RFPs etc. made by the employee during his tenure in PITB.
3. Equipment issued and handed over to the successor. (List attached as Annexure A).

EMPLOYEE________________________
SUCCESSOR _______________________
 EMPLOYEE EXIT AND CLEARNACE

Part C: Clearance by other Departments

Employee Name: ____________________ File #: ______________________

Department:_____________________

Designation: ____________________

Date of Leaving: ______________________

It is certified that nothing is outstanding against the above mentioned employee.

Finance Dept ______________________________________ JD Finance

Admin Dept_______________________________________ Director (Admin)

Store Dept________________________________________ Inventory Supervisor

Technical Dept ____________________________________ Programme Officer

HR Dept _________________________________________ Director (HR)

Transport _________________________________________ AD (Transport)

SecurityDept________________________________________________________________

___________________________________________________________________________

Note:
1. Only officer in charge can sign this document.
2. It is the responsibility of employee’s Parent department to complete this document
and submit it to HR Department.
 EMPLOYEE EXIT AND CLEARNACE

Part D: Clearance by Concern Departments

Employee Name: ________________________ File #: ____________

Department: __________________________

Designation: __________________________

Handing-Taking Documents

Sr. No Documents Project Name

Soft Copy Hard Copy
01 SRS
02 Project Proposal
03 Request for Proposal
04 Request for Bids
05 PC1
06 Terms of Reference
07 Proposal Evaluation Sheets
08 Manuals
09 Tenders
10 Contracts
11 Presentations
12 Deliverables

Handed Over By Taken Over By

__________________________ ____________________________

Mr. / Ms. Mr. /Ms.

Verified By

____________________________

Mr. / Ms.
 EMPLOYEE EXIT AND CLEARNACE

Handing-Taking Equipment

Date: ___________________________________

Department: _____________________________
S/NO Item Qty Brand Serial No Remarks
01
02
03
04
05
06
07

Handed Over By Taken Over By

________________________ __________________________

Mr./Ms. Mr./Ms.

Verified By

__________________________________

Mr. / Ms.

Handing-Taking Others

Sr./No Item Qty Meter Reg No Remarks

Reading
01
02
03

Handed Over By Taken Over By

_______________________________ _________________________