Check List

for Employee's Final Settlement

Date:

______/_______/__________

Description

1 Approved Resignation by Employee or Job Termination Email from competent authority

2 Exit Clearance Certificate signed by all concerned Departments

3 Attendance and Leaves Record

4 Verfied Payables/Outstanding Balance from Accounts Department

HR Comments (if required)

HR Department

HR Officer/Mana

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Check List

ee's Final Settlement

Status

HR Department

HR Officer/Manager

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Human Resource Manual

Employee's Final Settlement

Date:_______/______/_________

Location

Employee Information
Employee Code (Primary / Secondary)
Employee Name
Designation
Department
Monthly Salary
Date of Joining
Date of Resignation
Date of Seperation (Last Working Day)
Status of Seperation (Resignation/Termination/Dismissal)
Status of Employment (On Probation/Permanent)
If Permanent, short notice period (i.e. number of short days from one month notice period
Notice period not applicable if employee was on probation

Payable Salary/ies
Description

From

Duration
To

Salary for the month of _______________ 2015

Salary for the month of _______________ 2015

Total Payable Salary/ies --------------- (A)

Miscellaneous Payables (Medical/Arrears/Bonus/Points etc.)

Total for Miscellaneous Payables -------------(B)

Total Payables (A+B) -------------------------------- (C)

Deduction/s
Short notice period deduction for ___________ days. i.e. [{(Monthly SalaryX12)/365}XShort Days]
Deduction against __________ extra leaves (over and above allowed limit)
Loan/Advance against salary
Income Tax Deduction (if applicable)
EOBI Deduction for the month/s of ____________________(i.e. Employee Share)
Outstanding as per Accounts ledger. (i.e. other than above deductions)

Total for Deductions ------------- (D)

Net Payable/(Recoverable) ------------------ (C-D)

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Employee's Final Settlement

Date:_______/______/_________

Location

Employee Information
Prepared and Checked by

Checked by

HR Officer

HR Manager

Undertaking

I hereby declare that I have checked and received all my dues from Kitchen Cuisine (Pvt.) Limited and h
claim against company.

Signature of Employee

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Left Hand Thumb Impression (for

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Human Resource Manual

e's Final Settlement

Duration
Days Worked

Amount

es --------------- (A)

ts etc.)

Payables -------------(B)

--------------------------- (C)

Monthly SalaryX12)/365}XShort Days]

allowed limit)

Employee Share)
deductions)

ns ------------- (D)

e) ------------------ (C-D)
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e's Final Settlement

Verified by

Accounts

Undertaking

ues from Kitchen Cuisine (Pvt.) Limited and have no further

Left Hand Thumb Impression (for female/s Right Hand's)

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Exit Clearance Certificate

Date:_______/______/_________

Location

Employee Information
Employee Code (Primary / Secondary)
Employee Name
Designation
Department
Date of Joining
Date of Resignation

Concerned Department/s Exit Clearance

Department

Name of Activity Manager /

Authorized Person

Signature with Date

Production
Stores
Purchase
Accounts & Finance
Operations
Security
Transport
Admin.
Human Resources

Location Manager's Comments

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Exit Clearance Certificate

Date:_______/______/_________

Location

Employee Information

Comments by HR Department for the proceeding of Final Settlement

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arance Certificate

partment/s Exit Clearance

Comments

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arance Certificate

Name and Signature

HR Officer/Manager

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