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AMARTA

SUNSET LOUNGE AND BAR

EMPLOYEE CLEARANCE FORM

EMPLOYEE CERTIFICATION:

Employee Name: Last Day of Employment:


Type of Separation:  Resignation  Retirement  Other

Upon separation, I understand that I have an ongoing responsibility to maintain the confidentiality of
any employee information to which I may have had access during my employment with the Samana
Resort.

Employee Signature: Date:

HIRING DEPARTMENT CLEARANCE:

□ Completed one month notice Sign :__________


□ Name tag, Uniform, HT, Locker key Sign :__________
□ Transportation Sign :__________
□ Department property returned (Computer, Cell phone, etc.) Sign :__________
□ Final count AL, DP, EO. Sign :__________

Supervisor Name: Title:

Supervisor Signature: Date:

HUMAN RESOURCES:
□ Procurement/Credit Cards  Systems Access  POS  Final Pay

AMARTA HR Signature: Date:

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