Вы находитесь на странице: 1из 2

EXIT CLEARANCE FORM

Employee Detail Employee Name Division Date of joining Date Of Resignation Vivek Shirkhedkar General Medicine 01/01/1900 01/11/2012 Location Designation Employee No. Last Working Day GOA Medical Representative 01494 31/10/2012

Future Contact Details of the Separating Employee : Address Telphone No. Plot No.4,Naik Layout,Subhashnagar,Jaytala Road,Nagpur-440022 (Maharashtra) 0712-2220006 Email Mobile IMMEDIATE SUPERIOR / BU HEAD 1. Work in Progress Handover 2. Company Property Returned (Yes/No) 3. Mobile / Data Card Returned Yes Employee Sign vivskar@yahoomail.co.in 9422115060

Yes

BU Head Name

NA Files Uploaded:

Sign Remarks if any

4. TES to be paid (Approved hard copy attached)

1. Oct Tes.docx 2. SEP TES.docx

5. Laptop Handed Over 6. Car Returned 7. Notice pay to be given or not 8. KRA Payout to be given or not

NA NA

ADMINISTRATION 1. Hardware (Laptop, Pendrive, R-Connect Card etc) 2. Software Access, if any 3. Login ID & Password 4. Email ID Deactivated 5. Desk Phone PIN Disabled Employee Sign Admin Mgr Name Sign Remarks if any Date Date Employee Sign IT Mgr Name Sign Remarks if any FINANCE AC CODE 1. DGM Advance 2. Travel Imprest ACCOUNT HEAD Employee Sign Fin Mgr Name

IT

1. ID / Access Card

2. Company Provided Car

3. Keys to the cabinet 4. Mobile Handset Recovery / Data Card

AMOUNT (If any)

pd4ml evaluation copy. visit http://pd4ml.com

3. Loans to employees 4. Salary Advance 5. Other advances to staff 6.Travel Advance 7. Any other recoveries

Sign Remarks if any

LEGAL : POWER OF ATTORNEY Employee Sign Legal Mgr name Sign Date HUMAN RESOURCES 1. Leave Balance 2. PF Withdrawal Forms 3. Gratuity, if applicable 4. Investment Proofs submitted 5. Notice Pay Recovery ( No. of days) REMARKS, If any : Sign HR Mgr Name Employee Sign Date Remarks if any

Status :

In Progress

pd4ml evaluation copy. visit http://pd4ml.com

Вам также может понравиться