Document No.

5-
PROCEDURE FOR 8900-2007-F1
TRANSFER AND POSTINGS Rev. No. 0
Page 1 of 2

CLEARANCE CERTIFICATE
NAME : SUSIL KU. NAYAK
EMP NO. : 43BA
DESIGNATION : OFFICER GR.V (SAFETY)
DEPARTMENT : CONTRUCTION
DATE OF TRANSFER/ RESIGNATION/ RETIREMENT/ VRS : 25-01-2023

PART –I

(Handing over / Taking over certificate)

On being released on transfer/ resignation/ retirement/ VRS via E-mail dated 17-JAN-2023, I, hereby hand over the
charge pertaining to my work at DHPL- BALASORE GAIL CAMP Office to Shri. KHURSHID ANWAR E. No.
Designation OFFICER GR.IV (SAFETY) and hereby hand over all the documents, files, records etc. to him. (List attached,
Annexure-1).

(SIGNATURE OF PERSON TAKING OVER) (SIGNATURE OF PERSON HANDING OVER)

PART – II

Handing over of Metal Stamp (In case of resignation/retirement/VRS only)

Status of metal stamp issued to the employees to be checked from List of Welding/NDT Engineer and List of personnel other
than Welding/NDT with metal stamp available online on construction portal as per Doc no: LL-1943-0004 & LL-1943-0005.

Metal stamp handed over: Yes/No/Not applicable

(Strike whichever is not applicable)

If yes, copy of clearance certificate along with metal stamp to be sent to Divisional QA Manager for updating of records at HO.

(In case of any query / discrepancy, Div. QA Manager may be contacted).

(DEPARTMENTAL HEAD)

PART - III

Shri/Ms. E.No. Designation has handed over

charge as directed and he/she may be released as required.

(DEPARTMENTAL HEAD

PART – IV
(Clearance from other departments)
I. Technical Library

Description of Out standing books/codes etc. if any - Value (Rs)

Dealing Assistant Countersigned

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 Document No. 5-
PROCEDURE FOR 8900-2007-F1
TRANSFER AND POSTINGS Rev. No. 0
Page 2 of 2
II. Stores

All non-consumable items issued to the employee have been returned, excepting the following items, if any.

Description of item - Value (Rs)

Dealing Assistant Countersigned

III. Estate Department

Position of handing over of allotted Quarter– discrepancy, if any to be mentioned.

Dealing Assistant Countersigned

IV. HR Department

He/ She has submitted Leave application and filled Time sheets upto the date of his/ her release. Identify card
has/ has not been surrendered.

Dealing Assistant Countersigned

V. F&A Department

Certified that nothing is due from the employee – discrepancy, if any to be mentioned.

Dealing Assistant Countersigned

Forwarded for making final payment after adjusting dues, if any; according to the records and in line with the details
mentioned in this Clearance Certificate.

(DEPARTMENTAL HEAD)

DISTRIBUTION

Field Personnel Cell

F&A Dept.
Concerned Employee

Template No. 5-0000-0001-T2 Rev. 1 Copyrights EIL – All rights reserved