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2 nd Floor – Quirante Building

Purok San Jose, Brgy. Baybay


Liloy, Zamboanga del Norte, Philippines 7115
Tel: 065-917-8707

EXIT CLEARANCE CHECKLIST


(This form should be completed on your last working day. No clearance, No Certificate of Employment, No SA Cancellation)

Complete name: ___________________________


Teacher’s name: ___________________________
Last Day of Service: ___________________________

Authorization Date Signed Remarks


Signature

Company Issued Properties


Company ID
Cubicle
Office Key
Computer Peripherals:
System Unit
Mouse
Keyboard
Headset
Camera
Monitor
Others

SIGNED BY EMPLOYEE:

__________________________ ____________________
Printed name over signature Date of Completion

RECEIVED BY CENTER MANAGER:

__________________________
Printed name over signature

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