PEOPLE SERVE MULTI-PURPOSE COOPERATIVE

STATEMENT OF MEMBER-OWNER ACCOUNTABILITIES

NAME: CONTACT MEMBER-OWNER STATUS: DATE HIRED: DATE
NUMBER Associate Regular SEPARATED:
Seasonal

CLIENT COMPANY / BRANCH / POSITION: NATURE OF SEPARATION: DATE FILED:

DEPARTMENT End of Services Resigned Others:____________

INSTRUCTIONS TO BE STRICTLY FOLLOWED:

1. Clearance should be processed by the Member-Owner.
2. Member-Owner should submit this clearance on or before their last day of work ____________________________
to PSMPC MOAIC to avoid delays in final pay. MEMBER-OWNER SIGNATURE
3. Member-Owner will be notified upon the release of their final pay OVER PRINTED NAME
DEPARTMENT AUTHORIZED SIGNATORY ACCOUNTABILITY DATE
PRINTED NAME SIGNATURE DUE FROM MEMBER-OWNER RELEASED
1. Store or Department Concerned
a. Dept. Head (if Operations)
b. Treasury Head (if Treasury)

2 Warehouse

3 Canteen

4 Accounting
Shortages & other accountabilities
5 Human Resources Department

PEOPLE SERVE MULTI-PURPOSE

COOPERATIVE
5. HR & Operations Department (HO)
a. HRMD Head (ID, ATM)
SMOA # __________
7. Payroll (Head Office)
a. Payroll Head (Uniforms)

CERTIFIED CLEARED:
_______________________________________ _______________________________________
Personnel / Department / Store Manager PEOPLE SERVE MULTI-PURPOSE
COOPERATIVE

PEOPLE SERVE MULTI-PURPOSE COOPERATIVE

STATEMENT OF MEMBER-OWNER ACCOUNTABILITIES
NAME: CONTACT MEMBER-OWNER STATUS: DATE HIRED: DATE
NUMBER Associate Regular SEPARATED:
Seasonal

CLIENT COMPANY / BRANCH / POSITION: NATURE OF SEPARATION: DATE FILED:

DEPARTMENT End of Services Resigned Others:____________

INSTRUCTIONS TO BE STRICTLY FOLLOWED:

1. Clearance should be processed by the Member-Owner.

2. Member-Owner should submit this clearance on or before their last day of work ____________________________
to PSMPC MOAIC to avoid delays in final pay. MEMBER-OWNER SIGNATURE
3. Member-Owner will be notified upon the release of their final pay OVER PRINTED NAME

DEPARTMENT AUTHORIZED SIGNATORY ACCOUNTABILITY DATE

PRINTED NAME SIGNATURE DUE FROM MEMBER-OWNER RELEASED
1. Store or Department Concerned

a. Dept. Head (if Operations)

b. Treasury Head (if Treasury)

2 Warehouse

3 Canteen
4 Accounting
Shortages & other accountabilities
5 Human Resources Department

PEOPLE SERVE MULTI-PURPOSE

COOPERATIVE

5. HR & Operations Department (HO)

a. HRMD Head (ID, ATM)
SMOA # __________
7. Payroll (Head Office)
a. Payroll Head (Uniforms)

CERTIFIED CLEARED:

_______________________________________ _______________________________________
Personnel / Department / Store Manager PEOPLE SERVE MULTI-PURPOSE
COOPERATIVE