CLEARANCE FORM

EMPLOYEE DETAILS
Employee Name: Employee No.:
Position: Last Day of Service:

This is to confirm that I __________________________ a former _______________ (position)

of TRI-S MANPOWER MANAGEMENT SERVICES. currently at _______________ branch would like to

attest the following statements below as true and any falsification alteration would result in non-release

for my final pay clearance unless cleared of any disputes by the Management.

NOTE:

 The relevant items listed below must be returned before you leave the Company.
 Gadgets, USB, Company ID and other Hard Copy Documents must be sent back to Head Office.
 This form should be returned to HR-Department, on or before the Last working day.
 Please do not keep any of the field empty, as incomplete form will not be entertained
 Some of the fields may not be applicable to all, in such case please mention N/A.
 Payroll Department will NOT pay any monies or hand over any documents until all the
necessary signatures appear on this form and the form is handed to the Human Resources
Department.
 Final Acknowledgement should be signed by the Department Head/Supervisor.
 Departments Supervisor is needed during the turn over period.

Employee Signature:
Date:

Signature:
Description: Remarks Date
Received/Actioned by
Username:
Company use Email
Password:
Any budget deposited in the
ATM

Monetary return

Liquidations

Desktop (Mouse, Speaker)

Suite 407 Columbian Building, 160 West Avenue, Quezon City

trismmshrd@gmail.com
Laptop and charger (if
applicable)

USB (if applicable)

Company Phone/Sim (if

applicable)

Company ID

Company Cash Advancement

SSS or Pag IBIG Loans

Advancement

Signature:
Documents: Remarks Date
Received/Actioned by

Suite 407 Columbian Building, 160 West Avenue, Quezon City

trismmshrd@gmail.com
REMARKS:

Employees Signature:
Signature over printed name Date
Received By:

Signature over printed name Date

Witnessed By:
Signature over printed name Date

Suite 407 Columbian Building, 160 West Avenue, Quezon City

trismmshrd@gmail.com