Exit Clearance Form

Form to be attached to personal record

Employee: Date:
Employee ID: Employment Date:
Position: Supervisor:
Account: Last Day of Employment:

Contact Information
Address:
Cell/Home #:

Type of Separation
_____ Resignation _____Termination _____Retirement _____Others

Reason for Leaving

_____ Non Regularization _____ Health Reasons _____ Personal Reasons
_____ Continue Education _____ New Job Opportunity _____ Relocation
_____ Other (specify)

Operations
Information System Credentials System Tool Credentials
Work Email: Username:
Password Password:

Employee Responsibility

I have surrender all [Tick that apply] which were entrusted to me during my employment

_____ Company ID Badge _____ Access Card

_____ Locker Key _____ HMO Card

I understand that my OnSpot Global email address will be deactivated the day after my official
work and I have notified appropriate email contracts of this change.
Clearance

Immediate Superior
Name:
Position:

Status
_____ Cleared ____ Not Cleared _____On Hold

Reason:
Signature:

HR Department

Claims
Last Date of Pay:
Release Date:

Name:
Position:

Status
_____ Cleared ____ Not Cleared _____On Hold

Reason:

Signature:

Employee Acknowledgement

I acknowledge my obligation to maintain responsibility and confidentiality of my information and

work credentials.

_____________________________
Signature over Printed Name / Date
1. What are you going to do?

__________________________________________________________________________________________
2. If employment, what prompted you to start looking for another job?

__________________________________________________________________________________________
3. If employment, who will be your new employer?

__________________________________________________________________________________________
4. Do you think management adequately recognized your contributions? If not, how do you think recognition
could be improved?

__________________________________________________________________________________________
5. Were there any company policies you found difficult to understand? If so, how can the firm make them clear?

__________________________________________________________________________________________
6. Do you feel the description of your job in the engagement process was accurate?

__________________________________________________________________________________________
7. Were the purpose and expected results of your position clear throughout your work in the unit?

__________________________________________________________________________________________
8. Could your qualifications, experience, and skills have been used to better advantage?

__________________________________________________________________________________________
9. Do you feel you received appropriate support to enable you to do your job?

__________________________________________________________________________________________
10. Was the training you received in the company adequate to enable you to accomplish your job?

__________________________________________________________________________________________
11. Are there further training opportunities you think the company should be offering?

__________________________________________________________________________________________
12. What did you see as your promotion and career prospects in the company?

__________________________________________________________________________________________
13. How might those prospects have been improved?

__________________________________________________________________________________________
14. How was your working environment generally?

__________________________________________________________________________________________
15. Can you list the three most important things that should be done to make the company more effective in terms
of influencing decisions in the organization?

__________________________________________________________________________________________