You are on page 1of 2

BIORAD MEDISYS PVT.

LTD, PUNE

Title: Clearance Form

Clearance Form
Employee Name: Chetan Pakhare Reporting Manager: Debasish Pradhan
Employee Code: Bio/Med/4143
Department: Research, Design & Development
Division: Orthovasive
Last Date of working: 31st Mar 2022

Sr. No. Department Description Comments Sign


Current Pending
Tasks
1 Department Head Hand over
Documents
Files (Soft & Hard)

Company Loan
Advance
Accounts &
2 Financial Liabilities
Finance
Expenses
Bill Liability

Stationary
Visiting cards
I card
3 Admin Letter Heads (If
Given)
Cabin/ Drawer Keys
Car (If Applicable)

Laptop & Accessories


Mobile &
Accessories
4 IT Login ID
Pen Drive, Data Card
CDs & Floppies

5 HR Salary
Relieving
Form No:- BRP/ADF/004/16/02 Unauthorized Copying Prohibited Page 1 of 2
letter/Experience
Letter
BIORAD MEDISYS PVT. LTD, PUNE

Title: Clearance Form

Miscellaneous

Instruments
Implants / Demo
6 Stores Implants
Tools
Any Other Material

Instruments
Implants / Demo
7 FG Stores Implants
Tools
Any Other Material

8 Production Dept.

I hereby declare that I have handed over all my charge and company property to all respective
departments.

Employee Signature: Reporting Manager:

Date:
HR:

Form No:- BRP/ADF/004/16/02 Unauthorized Copying Prohibited Page 2 of 2

You might also like