Annex 12 Clearance Form

Manpower Name : ZTE ID :

Number
Subcontractor : PO Number :
Date of Termination : Project :
Mailing Address :

Telephone Number: : Private :

Email Add.

Type of Service Termination (Please tick one)

 Resignation  Retrenchment  Term Contract Ended  Dismissal
 Other. Please specify

ZTE Supervisor
Yes N.A. Receiver’s Remark
Signature, Name
& Date
Job & documents handed over
Others :
( Signature & Sign):

ZTE Project Administration/Project HR

Yes N.A. Receiver’s Remark
Signature, Name
& Date
Keys (to Draws, Cabinets & etc) Returned
Business Card Returned
Stationery Returned
Others :
( Signature, Name & Date):

ZTE Outsourcing Department

Yes N.A. Receiver’s Remark
Signature, Name
& Date
Lotus ID Deactivated
Others
( Signature, Name & Date):

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Subcontractor HR Department
Yes N.A. Receiver’s Remark
Signature, Name
& Date
ID Badge Returned
Computer & Peripherals Returned
Others
( Signature, Name & Date):

Submitted by

——————————————————
Manpower/Date (Signature):

Confirmed by

——————————————————
Subcontractor HR /Date (Signature):

Approved by

———————————————————
ZTE Project Manager/Date (signature)

Note:Subcontractor must attaché this scanned Clearance Form as supporting document in the last pre- reception

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application in SCM.