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EXIT CLEARANCE FORM

F - MARKETING DEPARTMENT CLEARANCE (RESTAURANT/LIFESTYLE/CORPORATE)


FILLED IN BY: General Marketing Manager DEACTIVATION/RETURN CHECKLIST:
FOR LEVEL: All Level and Positions (Only for Employee of Marketing Dept) YES NO N/A
1 - MARKETING DIVISION: Access to Social media Platform (Instagram, facebook, etc)
2 - CREATIVE DIVISION: Camera & Accessories
3 - Access to Social Media (Instagram, Facebook, etc)
4 - Other Work System Clearance: Solva, Oracle Responsys (Go to Page 1, IT section on Work Systems)
5 - Others
REMARKS: VERIFIED BY
NAME SIGN DATE

G - ASSET MANAGEMENT DEPARTMENT CLEARANCE


FILLED IN BY: Asset Management Manager RETURN CHECKLIST
FOR LEVEL: All Level and Positions (Holding) YES NO N/A
Company Vehicle Clearance:
1 - Car / Motorcycle:
2 - Keys for Car / Motorcycle all sets:
3 - Vehicle Registration Certificate
4 - Vehicle Manual Book:
5 - Miscellaneous tools/Vehicle accessories:
6 - Others
REMARKS: VERIFIED BY
NAME SIGN DATE

H - OPERATIONS DEPARTMENT CLEARANCE


FILLED IN BY: Area Manager (Resto Division) / Operations Manager (Lifestyle Division) DEACTIVATION/RETURN CHECKLIST:
FOR LEVEL: All Level and Positions (Only for Employee of Operations Dept) YES NO N/A
1 - Store Keys
2- Store room Key
3 - Brankas Keys
4 - Brankas Password Change
5 - Laptop Handover
6 - Ipod / Tablet Handover
7 - Work System Clearance: Chope (Go to Page 1, IT section on Work Systems)
8 - Others
REMARKS: VERIFIED BY
NAME SIGN DATE

I - HUMAN RESOURCES DEPARTMENT CLEARANCE


FILLED IN BY: Employee Relations Supervisor and/or Manager DEACTIVATION/RETURN CHECKLIST:
FOR LEVEL: All Level and Positions YES NO N/A
1 - Staff ID Card
2 - Uniform
3 - DM/ENT Deactivation
4 - DM/ENT Card
5 - GRAB Corporate Account
6 - Work System Clearance: Sunfish, GreatDay, The Force, VIDA (Go to Page 1, IT section on Work Systems)
7 - Business Card
8 - Insurance Card
9 - HR Office Key
10 - HR Cabinet/HR Drawer Keys
11 - Others
REMARKS: VERIFIED BY
NAME SIGN DATE

PLEASE NOTE:
1. Please make sure that this exit clearance form is completed and signed by the relevant department head on your last day of work.
2. You are to submit this form to Human Resources Office (Employee Relations) and schedule exit interview session within 7 days.
3. Exit interview is performed at HR Office at Jl. Pela Raya no. 8, Kramat Pela, Jakarta Selatan. Contact us via: HR Hotline number: 0812 8484 8620 or Office
Phone No: 021-7207118
4. Exit Interview Schedule: Every Tuesday and Friday at 10.00 - 16.00 (local time). (During Covid-19 pandemic, office hours may differ. Please contact HR
Employee Relations team to make appointment).
5. Failure to perform exit interview will result in suspension of payroll and benefits.

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