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ZKB-Reli/HSE/CL

Form/01 Rev”01”
Dec.20, 2016

Employee Clearance Form

Employee Name: ------------------------------ Employee ID: ---------------------------


Department: ------------------------------ Date: ---------------------------
Position: ------------------------------
Joining Date: ------------------------------ Ending Date: ---------------------------

Reason for Clearance:

Resignation (Attach Resignation)


Termination (Attach Disciplinary report)
Retirement (Attach notice of retirement)
Project Based
Other (Please Specify)
The Above mentioned employee is hereby given clearance from all money and property accountability.

Sr.# Authorized Signatory Signature Date Remarks


1 Supervisor/ Head
3 Residence/ Hotel
4 HSE Manager/Incharge
5 Main Store
6 Project Manager

 Filled form must be submitted to HR department before last working day.


 If No form will be submitted on due date the remaining tool in account of respective
employee will be charged in due amount from the final bill of the respective contractor.

Employee Admin/HSE Manager


Project Manager

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