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    Form CCL Dian Pertiwi

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    pertiwidhyan1
    This document is a clearance checklist for an employee, Dian Pertiwi, leaving her position as a Sales Assistant at the Jkt Ted Baker Ladies Galeries Lafayette store. It lists 16 items to be checked off confirming the return of company assets and settling any outstanding financial matters. These include returning her resignation letter, company credit cards, uniforms, and settling her health insurance balance. The form requires signatures from the employee, her direct manager, and HR to verify the completion of all exit items.

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    Form CCL Dian Pertiwi

    Uploaded by

    pertiwidhyan1
    31 views1 page
    This document is a clearance checklist for an employee, Dian Pertiwi, leaving her position as a Sales Assistant at the Jkt Ted Baker Ladies Galeries Lafayette store. It lists 16 items to be checked off confirming the return of company assets and settling any outstanding financial matters. These include returning her resignation letter, company credit cards, uniforms, and settling her health insurance balance. The form requires signatures from the employee, her direct manager, and HR to verify the completion of all exit items.

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    This document is a clearance checklist for an employee, Dian Pertiwi, leaving her position as a Sales Assistant at the Jkt Ted Baker Ladies Galeries Lafayette store. It lists 16 items to be checked off confirming the return of company assets and settling any outstanding financial matters. These include returning her resignation letter, company credit cards, uniforms, and settling her health insurance balance. The form requires signatures from the employee, her direct manager, and HR to verify the completion of all exit items.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    31 views1 page

    Form CCL Dian Pertiwi

    Uploaded by

    pertiwidhyan1
    This document is a clearance checklist for an employee, Dian Pertiwi, leaving her position as a Sales Assistant at the Jkt Ted Baker Ladies Galeries Lafayette store. It lists 16 items to be checked off confirming the return of company assets and settling any outstanding financial matters. These include returning her resignation letter, company credit cards, uniforms, and settling her health insurance balance. The form requires signatures from the employee, her direct manager, and HR to verify the completion of all exit items.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

    CLEARANCE CHECKLIST

    Nama Karyawan / Employee Name Dian Pertiwi

    Nomor Induk Karyawan / Employee ID 23017022

    Jabatan - Level / Position - Grade Sales Assistant (STORE/OFFICE)*


    Pekerja Harian / Kontrak / Probation / Permanen / Management Trainee
    Status Karyawan / Employee Status*
    Daily Worker / Contract / Probation / Permanent
    Nama Toko - Kode Toko / Store Name - Code Store Jkt Ted Baker Ladies Galeries Lafayette (TB06)

    Tanggal masuk / Join Date 15. Aug. 2023

    Tanggal Terakhir Bekerja / Last Working date 31. Dec. 2023


    Dengan ini menyerahkan kembali seluruh aset , perlengkapan milik Perusahaan yang diserahkan kepada saya, beserta penyelesaian biaya-biaya perorangan yang terjadi selama bekerja
    di lingkungan PT. Mitra Adiperkasa, Tbk. & Grup :
    Herewith I was handed up all of company asset, equipment, and tools that was delivered to me included completion on individual cost during my working periode in PT. Mitra Adiperkasa,
    Tbk and Groups

    No Item To Be Sign Yes/No Store Office


    Surat Pengunduran Diri Superior (Atasan
    1 Yes
    Resignation Letter Langsung)
    Barang Hilang
    2 OIC / Superior No
    Missing Item
    Outstanding Setoran Penjualan Harian Toko (Tunai dan Non Tunai) Retail Admin
    3 No
    Outstanding Store Sales Deposit Daily Cash and Voucher) (RACS)
    Kas Kecil, Outstanding Kas Bon Finance (to be handle by
    4 No
    Petty Cash, Outstanding Advance HR)
    Mobil / Sepeda Motor
    5
    Car / Motor Cycle
    Telepon Genggam / BlackBerry, Kunci Apartemen * General
    6 No
    Mobile phone / BlackBerry, Apartment Key Affair
    Voucher Taksi
    7
    Taxi Voucher
    Kartu Kredit Perusahaan Corporate
    8 No
    Company Credit Card Treasury
    Ikatan Pelatihan Retail School/HR
    9 No
    Training Bonding (lantai 28)
    Lain-lain : Seragam, Kunci, Exit Interview, dll
    10 HR Fashion 1 No
    Others : Uniform, Lock, Exit Interview, etc.
    Kartu (ID KARYAWAN, ASURANSI KESEHATAN, AKSES GEDUNG
    11 dilampirkan)* HR Fashion 1 No
    ID Card (Employee, Health, Travel Insurance,Access Card)*
    Kelebihan Asuransi Kesehatan No
    12 HR Fashion 1
    Overlimit of Health Insurance
    Sisa Cuti dan Absensi Yes
    13 HRIS (to be handle by HR)
    Annual Leave Balance and attendance 5
    Pinjaman Koperasi / BPR / Perusahaan Koperasi (to be handle by
    14 No
    Loan HR)
    Deactivated Application/Account:
    a. E-mail Account & Directory Access ** : ……………………………………………
    15
    b. SAP, FI/CO, ETP **
    c. VPN remote access ** IT No
    Komputer Jinjing **
    16
    Laptop
    Diserahkan Oleh / Prepared by, Disetujui Oleh / Approved by, Diterima oleh / Received by

    Dian Pertiwi Gama Tando ______________________


    (Employee) (AOM) ( )

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