Lot 138 Panipuan, City of San Fernando, Pampanga 2000

Phone: +63 45 455 1939 Mobile: +63 9213276388

www.venzonlighting .com

CLEARANCE FORM
Employee name: Employee #
Position: Department:
Date Filed: Date of Separation:

Instructions: The following areas must be cleared prior to release of final pay.

DEPARTMENT Name and Signature of Department Head Remarks

Department Head

Human Resources
Company ID
Employee Handbook
Exit Interview

Accounting Department
Payroll & Cash Advance

Purchasing Department
Inventory
Equipment

TYPE OF SEPERATION

Retirement
Resignation
End of
Contract
Transfer To: _________________________

This form is used to certify that all office property and other dues have been returned and the rights
of employee to access property or services have been appropriately discontinued.

Employee’s Signature

Department Head Signature

President