3C 3rd Floor, MG Tower, Shaw Blvd.

, Daang Bakal
Mandaluyong City, 1552

EMPLOYEE CLEARANCE FORM

Employee Name: Jecren G. Booc ID No.: DNA-400

Work Location: Cebu Position Title/Rank: Technical Engineer

Employee Status: Regular X Field Employee (Project- Based)

Work From Home (Project- Based)

Last day of active Employment:

Type: a. End of Contract effective:

b. Resignation effective: July 30, 2022

c. Transfer to another Department / Work Location:

d. Others:

Upon separated, I understand that I have an on-going responsibility to maintain the

confidentiality of company/ employer information to which I may have had access during
my employment. I understand that my final pay will be released only upon completion of
this Employee Clearance Form.
August 3, 2022

Employee’s Signature Date

FOR ADMIN/ HR/ FINANCE DEPARTMENT CHECKING/ VERIFICATION

ADMIN/ HUMAN RESOURCES DEPT. HANDED-OVER

Done
LAPTOP
CELLPHONE Not Issued
Not Issued
VEHICLE KEY
ID CARD Done

TOOLS/ EQUIPMENT Done

RESIGNATION LETTER RECEIVED Done

FINANCE DEPARTMENT REMARKS

N/A
Staff advances and other liabilities
N/A
Receipts handed to finance

IMMEDIATE SUPERVISOR REMARKS

Handed over the Report Done

Departments are responsible for costs associated with the failure to secure Silvestre Pareñas Ruth C. Jerusalem
company property & resources upon separation of an employee. Cebu Team Leader HR and Admin
Copy: HR Office, Finance Office, Employee.