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CLEARANCE FORM

Employee ID Hiring Date


131478 December 15, 2021
Name Date of Separation
Rowena Villalongja Platel May 15, 2023
Position Separation Reason
Team Manager
Account/Department Contact Number
Frontier Ops/ Copper Voice 09951719048
Immediate Superior Email Address
Miko Maki rowenavillalongja26@yahoo.com
CLEARANCE DETAILS
Cleared Date
Department Approving Authorities Accountabilities Remarks (If Any)
Yes No N/A Accomplished

Supervisor /
Team Manager
Signature Over Printed Name

Division /
Department
Head Signature Over Printed Name

Desktop / Laptop / NUC


Asset Monitor
Management Headset
Department Signature Over Printed Name Proximity Badge
Others
ID
Lanyard
Facilities and
Locker
Admin
Signature Over Printed Name Pedestal Key
Others
Leave Conversion
Employee
Relation Others
Signature Over Printed Name

SSS Loan Balance


Pending Claims
Compensation
and Benefits
Signature Over Printed Name Others

Unliquidated Cash Advance


Cash Reimbursement
Finance
Signature Over Printed Name Others

Payroll
Signature Over Printed Name

Employee Signature  Date Signed 


July 6, 2023

By signing this document, I hereby confirm that I fully understand and agree to the following terms and conditions related to my company-issued assets and equipment
during clearance processing. Further, I hereby authorize FPS to deduct any unreturned/damage assets and equipment from my final pay in case of my separation with the
company.

______________________________________________________
Signature Over Printed Name

27th Floor, Robinsons Cyberscape Gamma www.fpsinc.com


Topaz Road, Ortigas Center, Pasig City

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