Exit Clearance Checklist Sample

This exit clearance checklist is used to ensure an employee returns all company equipment and property before leaving their job. It includes sections to check off return of items like controlled manuals, business cards, keys, laptops, phones, security access, personal protective equipment, travel documents, outstanding financial matters, and a signature block for the employee to declare all company property has been returned.

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Exit Clearance Checklist Sample

Uploaded by

Fahim Idrus

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Available Formats

Download as PDF, TXT or read online on Scribd

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EXIT CLEARANCE CHECKLIST

Employee Name Legacy No

Department SAP No
Company Location

Please check (√) accordingly

Company Items / Equipment Personal Protective Equipment
Controlled Manuals Safety Helmet
Business Cards Safety Goggles
Drawer / Cabinet keys Coverall
Others: Others:
Signature & Name Signature & Name
Dept Mgr/Supv Dept Mgr/Supv

Travel Services Accounting

Employment / S Pass Cash Advance
Dependent Pass Salary Advance
KITAS / INDO Visa Personal Phone Charges
AMEX Corporate Card Bond Store Deductions
Unused Air Ticket AMEX Corporate Card
SOS Card Statement (Current / Unbilled)
Others: Others:
Signature & Name Signature & Name
Travel Services Accounting

IT Equipment / Phone Human Resources

Dell Latitude ( ) ID Access Card
Dell Optiplex ( ) Medical Card - Employee
Dell Replicator ( ) Medical Card - Dependent
Dell Monitor ( ) Medical Card
Dell Replicator Charger Season Parking
Dell Travel Charger Leased Vehicle
Dell Optical Mouse Others:
Dell Key Board Signature & Name
Network Cable HR
Kingston Security
Cable ( ) Talent Acquisition
Dell Carry Bag Access to Server (Recruitment)
Mobile phone and accessories
Others: Signature & Name
Signature & Name TA Manager
IT
I declare that the company issued items and equipments
Others (Please specify): in my possession have been returned to the relevant depts.

Employee Signature Date (dd-mm-yy)

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Exit Clearance Checklist Sample

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Exit Clearance Checklist Sample

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EXIT CLEARANCE CHECKLIST

Employee Name Legacy No

Please check (√) accordingly

Travel Services Accounting

IT Equipment / Phone Human Resources

Employee Signature Date (dd-mm-yy)

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