Sample Employee Clearance Form for companies, schools, colleges, universities and office to get the in writing clearance from employees, students and clients.
Employee Clearance Form Page 1
AH Foundation
Clearance Certificate
Certified that there is nothing outstanding against Mr./Ms. __________________________
Designation___________________ who is leaving the Job as (Manager) from (AH Foundation)
With Effect From___________________ Head Office DHA, LHR
Section/Signatures………………………
Store Section _______________________
Vocational Department _______________________
Canteen _______________________
Secretarial Department ________________________
Section Head _______________________
Manager Human Capital Development _____________________
Assistant Manager Administration __________________________
Manager Administration ________________________________
Accounts Department ______________________________
Marketing Department _____________________________
Employee Clearance Form Page 2
AH Foundation
FULL AND FINAL SETTLEMENT
Name ________________________ Father Name_____________________
Designation ____________________________
- Payable Salary for the Month of (if any) ______________________
- Refundable Security Deposit ______________________
- Leave En-cashment (if any) ______________________
Total _________________________________________________
Deductions/Less:
- Outstanding Loans (if any) ______________________
Advance Salary ______________________
Tax ______________________
Net Payable ______________________
Figures in words. _________________________________________
Acknowledgement:
I acknowledge the receipt of my full and final settlement of dues including outstanding salary to date & security deposit etc. I certify that nothing is due against (AH Foundation) on my behalf. Total amount received Rs. ______________
Signature of Employee ________________________
Accounts Manager HCD Manager Director President


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