Employee name: Date filed:

Position: Date hired:

Reason for separation: Date separated:

Dept Checklist (X) Remarks Signature / Date

Turnover of records/files (documentation)
DEPARTMENT

Turnover of pending activities/responsibilities

Completion of assigned responsibilities
Check contents of PC/laptop
Delete personal files in PC/laptop
Check area & pedestal for personal property
ACCOUNTING

Cash Advances
Loans
Liquidation
Loans
Reimbursements
Attach last pay computation
Return company issued property/equipment
(cellphone, laptop/PC set, etc)
Return ID
Return keys (for pedestal, etc)
Return HMO card
HR / ADMIN

Return business cards

Resignation letter
Delete access in Biometrics
Cancel access to email
Attach last attendance for the period
Contact information/forwarding address
Exit interview

This formally confirms that all Kittelson & Carpo Consulting documents, records and/or property in the
possession of Ms/Mr __________________________ have been returned and accounted for and that
she has completed the responsibilities that she is expected to perform prior her resignation on
______________________.

Clearance verified and certified complete:

Cheriza Sevilla Date signed

Finance and Admin Supervisor

A review of our records indicate that to the best of our knowledge, _____________________ has no
more accountabilities or pending responsibilities, and is therefore cleared of all or any accountabilities.

Approved by:

Derek Mernagh John Slyne