Employee Clearance Form
Personal Information
● Employee Name: ___________________________________
● Employee ID: _____________________________________
● Department: ______________________________________
● Position: _________________________________________
● Separation Date: __________________________________
Clearance from Departments
Immediate Supervisor
● Name: ___________________________________________
● Signature: _______________________________________
● Date: ___________________________________________
Checklist
● Return of equipment and documents
● Completion of pending work
● Handover of responsibilities
Human Resources Department
● HR Manager: _____________________________________
● Signature: _______________________________________
● Date: ___________________________________________
Checklist
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● Conduct exit interview
● Process final payroll
● Explain benefits and entitlements
IT Department
● IT Manager: ______________________________________
● Signature: _______________________________________
● Date: ___________________________________________
Checklist
● Revoke system access
● Collect IT equipment
● Backup data
Finance Department
● Finance Manager: __________________________________
● Signature: _______________________________________
● Date: ___________________________________________
Checklist
● Settle final expenses
● Collect corporate card
● Clear any outstanding amounts
Final Clearance
● Approved by: ____________________________________
● Signature: _______________________________________
● Date: ___________________________________________
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