Format for Employee Clearance Form for Resigning and Termination
[This is a sample Format for Employee Clearance Form for Resigning and Termination. You can follow this sample Employee Clearance form for companies, schools, colleges, universities, and offices to get them in writing clearance from employees, students, and clients. You need to modify this sample according to your needs.]
Employee Clearance Form (Page 1)
Company/Organization Name…
Clearance Certificate
Certified that there is nothing outstanding against Mr./Ms. (Employee name) — — —
Designation: [Job Position; who is leaving the Job as (Manager) from (Compamy/Foundation)]
With Effect From — — — — — Head Office (Address)
Section/Signatures — — — (Concern Aythority)
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)
Company/Organization Name…
FULL AND FINAL SETTLEMENT
Name (Employee name) — — — — — Father Name — — — — —
Designation (Last job position) — — — — —
Payable Salary for the Month of (if any) — — — — —
Refundable Security Deposit — — — — —
Leave En-cashment (if any) — — — — —
Total — — — — — (money Amount)
Deductions/Less: — — — — —
Outstanding Loans (if any) — — — — —
Advance Salary — — — — —
Tax — — — — —
Net Payable — — — — —
Figures in words. — — — — (Total Amount)
Acknowledgement:
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 (Company/Foundation) on my behalf. Total amount received (Money amount) — — — —.
Signature of Employee — — — —.
Accounts Manager — — Manager — — Director — — President
