Employee Exit Clearance Form PDF
Employee Exit Clearance Form PDF
Employee Exit Clearance Form PDF
By initialing below, I certify that I have complied with the Company Rules regarding the following items upon
separation. An employee is required to make a clearance to the respective Department before leaving the
Company. You are instructed to bring this form to the various Department as stated below to obtain Clearance
before the last salary can be released
Department Cleared / Approving Remarks
Not cleared Signature/ Date
I. Employee’s own department
a. Documents
b. Properties (Laptops, car, equipment)
c. Office key
d. Others: ___________________
II. Finance Department
a. Cash advances
b. Reimbursements
c. Loans
d. Others: ___________________
III. HRAD
a. HMO
b. Resignation letter
c. Leave balances
d. Timekeeping records
e. Unpaid salary
f. ID
g. E-mail/ Dropbox
h. Others: ___________________
___________________________________ __________________
Printed Name over Signature of Employee Date today
______________________________________________ __________________________
Complete Mailing Address Contact Number
The final paycheck and/or leave payout can be authorized for release to this employee upon the necessary approval
and receipt of the completed Exit Questionnaire and Clearance Form by the Human Resources Department.
HRAD APPROVAL