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STATEMENT OF FINAL SETTLEMENT REF.

MS-FS-005/12-007
Termination / Resignation
EMPLOYEE NAME: EMP NO:

JOB TITLE: COST CENTER:

JOINING DATE: RELEASE DATE:

AMOUNT PERIOD DAYS/ AMOUNT TOTAL


SALARY DETAILS RATE
HRS
DHS FROM TO DHS DHS
REMUNARATIONS

BASIC SALARY - -

HOUSING ALLOWANCE - -

TRANSPORTATION - -

OVER TIME - -

SUB TOTAL = 0.00

ANNUAL LEAVE - - -
LEAVE

LEAVE PAID - - -

SUB TOTAL = -

? DAYS PER ANNUM - -


GRATUITY

SUB TOTAL = -

ADDITION -
ADJUSTMENTS

-
DELETION -
-

SUB TOTAL = -
REMARKS

GRAND TOTAL 0.00

Prepared by: HR Approval: Finance Approval: RECEIVED BY :

SIGNED : SIGNED : SIGNED : SIGNED :

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