Form No: 09/01/05

No Demand Certificate Form

Date: --------------------------

A. Employee Details

Employee Name
Department Unit / Section
Position Grade
Date of Joining Date of Birth
Year of Services Age
Last Working Day

B. Reasons for Separation:

SN Reasons √
1 Resignation
2 Termination – Medical
3 Termination – Discipline
4 Termination – Other
5 Permanent Disability
6 Death
7 Other (Please specify)

I _____________________________ hereby confirm that I have received all

dues arising from my employment with Al Bashayer Meat Company (S.A.O.C.)
as detailed below, and I have no further dues or claims on the Company

SN Reasons √
1 My Salary up to my last working day
2 My Leave Balance encashment
3 My End of Service Benefit
4 My Leave Ticket entitlements
5 Medical bills
6 Any other claims (please specify)

Employee Signature: Date

Form No: 09/01/05

No Demand Certificate Form

C. Finance Department Comments :
This is to confirm that the above staff has paid all his loans (if any) and other financial
claims and has no further liabilities toward the Company

Finance Manager ------------------------------ Date: ----------------------

D. HR Department Comments:

HR - Manager ------------------------------ Date: ----------------------

E. CEO’s Comments

Signature ------------------------------ Date: ----------------------

Copy for Employee Personal File

Copy for Finance Department