EMPLOYEE EXIT CLEARANCE FORM HRD–04–2021-Rev. 1.

First Name Middle Name Surname

Employee No.: Immediate Supervisor:

Position: Department:

Date of Employment: Separation Date:

Contact No: Other positions held:

Reason of Separation: Resignation Termination

End of Contract Others
Receiving Personnel
Department Accountabilities Sign over printed
name/Date
Unit Monetary Value
The following items issued should be returned/turned over
prior to the scheduled separation from this company
Branch/Operations
a) I.D. set ____ d) Sprinter bag ___
b) Helmet ____ e) Polo Shirt ____
c) Jacket ____
Warehouse Driver/Transporter
a) I.D. set _____ a) I.D. set _____
b) Polo Shirt ____ b) Polo Shirt _____
HR/Admin c) Fleet Card _____
Office/Support
A) I.D. set _____ F) Polo shirt _____
B) Pedestal key ____ G) Computer Set ____
C) Office Records ____ I) Business Card ___
D) Postpaid SIM ____ J) HMO (Health Card)
E) ATM CARD ____ _____

HR Timekeeper: Ding Talk access

Fixed Asset Clerk (with signed Accountability Checklist)

QC/QA/Claims Dept. (for

Operations-based employees
only)
Finance Dept.
JMS Account Not applicable _____
IT Dept. Company Email Not applicable _____
Regional General Manager

DOCUMENTS ISSUED BY EMPLOYEE'S SIGNATURE DATE SIGNED

Exit Interview Form
Certificate of Employment
Release Waiver & Quit Claim
BIR 2316

Checked by: Approved by: Acknowledged by:

______________ _______________ _____________________

Admin - Inventory Immediate Superior HR & Admin Representative

__________________________
Employee’s Name and Signature
Date: ___________________