PSPL

CLEARANCE FORM

Name: Designation:
Date of Joining: Date of Resignation:
Last day at work: Notice Period:

(* To be completed before the Full and Final settlement is done)

Items Signature Signature of person

responsible to
take charge
Work / Activities Handover Immediate superior

(Notice Period to be waived off or not)

Books / Manuals/ Any other publications Admin HR
Locker Keys Admin HR
Pen drive (if any) Admin HR
Company ID Card Admin HR

Attendance / Leave of the last working month

Accounts (to be filled by Accounts Dept.)

Advance taken (if any)

Expenses settlement (if any)

Final settlement made: Date:

( ) ( )
Signature of the Employee: Signature of the Accounts Head:
Action follow up by Admin: 1.Cancellation of official Email ID.
2. Clearing the Desk.
3. Cancellation from Attendance system.
4. Closing of Personal File.