Scribd
Upload
79 views1 page

Employment Clearance

The Employee Clearance Form is a document used to confirm an employee's separation from the company, requiring verification of outstanding deliverables and obligations across various departments. Each department must assess and sign off on the employee's clearance status, indicating if they are cleared or if there are reservations. The form also includes an authorization for the company to deduct any financial obligations from the employee's final pay.

Uploaded by

Maria Teresa Bernabe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
79 views1 page

Employment Clearance

The Employee Clearance Form is a document used to confirm an employee's separation from the company, requiring verification of outstanding deliverables and obligations across various departments. Each department must assess and sign off on the employee's clearance status, indicating if they are cleared or if there are reservations. The form also includes an authorization for the company to deduct any financial obligations from the employee's final pay.

Uploaded by

Maria Teresa Bernabe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

COMPANY LOGO/NAME HERE

EMPLOYEE CLEARANCE FORM

EMPLOYEE DATE
NUMBER PROCESSED
EMPLOYEE
HIRE DATE
NAME
LAST DAY ON
POSITION
DUTY
This is to confirm that the above employee is separating from the company effective at the close
of business hours of his LAST DAY ON OFFICIAL DUTY.
Kindly verify your records and sign in the appropriate space upon assessing that the separating
employee has no outstanding deliverables, obligations or accountabilities with each of your
departments. Otherwise, please indicate your concern/s in the REMARKS column so that the
Company may be able to take further action.
REMARKS/
DEPARTMENT VERIFICATION RECOMMENDED ACTION
(IF ANY)
Turnover Checklist Cleared With Reservation  Hold Until Final Advice N/A
Other Considerations
IMMEDIATE SUPERIOR’S SIGNATURE OVER
PRINTED NAME / DATE =>
ADMINISTRATIVE DEPARTMENT
Company ID Cleared With Reservation  Hold Until Final Advice N/A
Employee Handbook Cleared With Reservation  Hold Until Final Advice N/A
Laptop/Computer Cleared With Reservation  Hold Until Final Advice N/A
Mobile Device Cleared With Reservation  Hold Until Final Advice N/A
Flash drive/ Hard drive Cleared With Reservation  Hold Until Final Advice N/A
Unreturned Cash Cleared With Reservation  Hold Until Final Advice N/A
Other Considerations
ADMINISTRATIVE APPROVER’S POSITION
SIGNATURE OVER PRINTED NAME / DATE =>
ENGINEERING DEPARTMENT
Mechanical Tools Cleared With Reservation  Hold Until Final Advice N/A
Keys (Building/Vehicle) Cleared With Reservation  Hold Until Final Advice N/A
Manuals/Books Cleared With Reservation  Hold Until Final Advice N/A
Uniform Cleared With Reservation  Hold Until Final Advice N/A
Unliquidated Petty Cash Cleared With Reservation  Hold Until Final Advice N/A
Other Considerations
ENGINEERING DEPARTMENT HEAD SIGNATURE
OVER PRINTED NAME / DATE =>
AUTHORIZATION TO DEDUCT ACCOUNTABILITIES

I hereby authorize COMPANY NAME. to withhold


from my FINAL PAY and other receivables all my
financial accountabilities and obligations to the
company or any of its representatives.
EMPLOYEE’S SIGNATURE OVER PRINTED NAME / DATE
CLEARANCE CERTIFICATION
This is to certify that the above employee has
completed the clearance procedures and that
payment of his/her final pay and other benefits, if
any, may be made. All outstanding obligations and
accountabilities with other departments as specified
above should be deducted from his/her final pay.
POSITION TITLE OF FINAL APPROVER/ DATE

You might also like