CLEARANCE FORM

FIRST NAME MIDDLE NAME LAST NAME DATE PREPARED

JULIANNA LICOS CARULLO MARCH 25, 2024

POSITION CLIENT COMPANY

REDEMPTION CREW TOM'S UNIVERSE INC.

DATE STARTED DATE FINISHED BRANCH ASSIGNMENT DEPARTMENT

SEPTEMBER 23, 2023 MARCH 22, 2024 FUN HOUSE - MONTALBAN TOWN CENTER OPERATION

EMPLOYMENT STATUS (Please check): CONTACT NUMBER EMAIL ADDRESS

( ) REGULAR ( / ) PROBATIONARY

REASON FOR DISCHARGE (Please check):

( / ) END OF CONTRACT ( ) EARLY END OF CONTRACT ( ) RESIGNED Effective Date:

CLIENT COMPANY
This is to certify that the above-named employee has been cleared of all money / records / equipment / tools / supplies accountabilities as of
date indicated below:
DEPARTMENT CLEARING OFFICER/HEAD REMARKS / SIGNATURE DATE

OPERATION (IMMEDIATE HEAD)

REDEMPTION

TECHNICAL

ACCOUNTING

OPERATION (BRANCH HEAD)

HUMAN RESOURCE (Coordinator)

ARLYN O. DACANAY
(Return Company ID, Name Plate &
Uniform-Patches only)

PAN ASIA MANPOWER & GENERAL SERVICES INC.

CLEARING DEPARTMENT NAME SIGNATURE DATE
HUMAN RESOURCES

ACCOUNTING

OTHERS
CHARGES / ACCOUNTABILITIES:

CUT OF PERIOD PAYROLL DATE

HOLD SALARY

FINAL REMARKS
NOTE: Every Tuesday from 8:00 AM to 5:00 PM is the only time when clearances can be submitted at the head office.
Your final pay will take two to three months to process.
Please provide two copies of your valid ID for our references.

CERTIFICATION:
I hereby certify that as of today,________________________________________, I am separated from the services of Pan Asia Manpower &
General ServicesInc. and that I have RETURNED all equipment, tools and properties (Mall ID, etc.) assigned to me. I further certify that I agree
with the above- mentioned reason for my discharge and that the completion of this Clearance Form is MY PERSONAL RESPONSIBILITY to the
company. I also agree to have all outstanding accountability deducted from my backpay.

JULIANNA LICOS CARULLO

Name and Signature of Employee