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Employee Exit Clearance Form

This document is an employee exit clearance form that must be completed when an employee separates from their position. It lists the employee's name, department, date of hire, supervisor, and employment status. Upon separation, the employee must return any company property to the appropriate departments, such as work files, training materials, laptops, ID cards, and more. Departments verify the return of items by checking boxes and signing. The form is then submitted to HR to complete the exit process. It also collects the employee's contact information and any pay owed like loans. The employee signs to authorize deductions from their final pay.

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Aubrey Sindian
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10K views

Employee Exit Clearance Form

This document is an employee exit clearance form that must be completed when an employee separates from their position. It lists the employee's name, department, date of hire, supervisor, and employment status. Upon separation, the employee must return any company property to the appropriate departments, such as work files, training materials, laptops, ID cards, and more. Departments verify the return of items by checking boxes and signing. The form is then submitted to HR to complete the exit process. It also collects the employee's contact information and any pay owed like loans. The employee signs to authorize deductions from their final pay.

Uploaded by

Aubrey Sindian
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EMPLOYEE EXIT CLEARANCE FORM

Name : Employee No.: Position Title:


Department : Date of Hire : Supervisor :
Employment Status:
Date of Separation: Reason of Separation: Failed Training
(to be filled out by HR)
Resignation AWOL
Termination End-of-
Contact

Instructions: The employee must secure clearance with his/her immediate superior and HRD, surrendering the
appropriate item(s) to each department. Accountabilities must be returned by the employee personally or a
representative authorized in writing if the employee himself/herself is incapable of doing so. The concerned
department should place a check mark (/) and sign on the space provided below to indicate if accountability has been
surrendered or not. Upon completion, the Employee's Clearance Form must be submitted to HR where employee is
guided through the final steps of exit process.

DEPARTMEN ACCOUNTABILIT SURRENDERED DATE & SIGNATURE


Y Yes No OVER PRINTED
NAME
T Operations Work Files Turnover
Training Manual (if
applcable) Others (please SDM/AM
specify)
IT Skype ID
Domain
ID Laptop
E-mail IT MANAGER
ID
Headset
Trainee's ID (P150.00)
Facilities/ Admin Company Mobile
Phone FACILITIES SUPERVISOR
Locker
Salary-deductable loan
Payroll
Cash Advances PAYROLL
Exit Notification SPECIALIST
Received Resignation Letter
Training/Probationary Fallout
Letter Exit Interview
HR HMO Card ID Card
Access/Proximity
Card Employee
Handbook Unused
Leave Credits
HR MANAGER
TOTAL AMOUNT COLLECTIBLE FROM EMPLOYEE P
EMPLOYEE CONTACT INFORMATION
Email Address(es) Home Address: Home &/or Phone Numbers:

I hereby acknowldege the accountabilities listed above and do authorize the Company's Payroll/Finance Dept to deduct said amount
from my final pay.
Approved:

Employee's Signature Over Printed Name General Manager


CLAIM FINAL PAY ON:
Note: Please bring this copy and 1 valid ID upon claiming your final pay

Flatworld Solutions (Philippines), Inc. | Human Resources | Exit Clearance | Internal

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