Employee Clearance Form Example

Want to make an employee clearance form? We are giving you a sample Employee Clearance Form for companies, schools, colleges, universities, and offices to get in-writing clearance from employees, students, and clients.

Best Employee Clearance Form Template

Please indicate the status of the following items:

Return of Company Property:

a. Office keys: [ ] Returned [ ] Not Returned

b. Company ID Card: [ ] Returned [ ] Not Returned

c. Laptop/Computer: [ ] Returned [ ] Not Returned

d. Company Phone: [ ] Returned [ ] Not Returned

e. Other (please specify): _________________________ [ ] Returned [ ] Not Returned

Return of Company Documents:

a. Employee Handbook: [ ] Returned [ ] Not Returned

b. Confidential Documents: [ ] Returned [ ] Not Returned

c. Other (please specify): _________________________ [ ] Returned [ ] Not Returned

Compliance With Company Policies:

a. Non-disclosure Agreement: [ ] Complied [ ] Not Complied

b. Code of Conduct: [ ] Complied [ ] Not Complied

c. Other (please specify): _________________________ [ ] Complied [ ] Not Complied

Final Payroll:

a. Final Paycheck: [ ] Received [ ] Not Received

b. Final Salary Slip: [ ] Received [ ] Not Received

Exit Interview: [ ] Completed [ ] Not Completed

Remarks: _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Employee Clearance Form Page 1

AH Foundation

Clearance Certificate

Certified that there is nothing outstanding against Mr./Ms. _________

Designation ______ who is leaving the Job as (Manager) from (AH Foundation)

With Effect From ________  Head Office DHA, LHR

Section/Signatures ………………….

Store Section __________

Vocational Department ________

Canteen __________

Secretarial Department _________

Section Head _________

Manager Human Capital Development _________

Assistant Manager Administration ______

Manager Administration __________

Accounts Department _______

Marketing Department __________

Employee Clearance Form Page 2

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AH Foundation

FULL AND FINAL SETTLEMENT

Name ______ Father Name ________

Designation ________

1. Payable Salary for the Month of (if any)    __________
2. Refundable Security Deposit                           __________
3. Leave Encashment (if any)                            __________

Total _________

Deductions/Less:

1. Outstanding Loans (if any)      ________

Advance Salary _______

Tax _________

Net Payable _________

Figures in words. _____________________

Acknowledgment:

I acknowledge the receipt of my full and final settlement of dues, including outstanding salary to date & security deposit, etc. I certify that nothing is due against (AH Foundation) on my behalf. Total amount received Rs. _____

Signature of Employee ______

Accounts Manager |HCD Manager | Director | President