7/29/2019 06-01-HR-F018

1/6

Form No: 06-01-HR-F018 Dhaka, Bangladesh.

Issue No:01

Other accessories (if required, please specify):

Name of Sales Centre: Base Town:

Division:

Employee Exit Clearance Form

PC (Full set) /Laptop/Printer/Scanner/Pen Drive:

If required, also deactivate item. Kindly where task is completed and N/A when applicable.

= Task Completed = Not Applicable

Date of Joining: Mobile Number:

Resignation Submission Date:

(only applicable for Sales & Depot personnel) (only applicable for sales personnel & SPR)

Resignation Effective Date:

Cotractual/TemporayCasualConfirmed Probation

Employee Name: Employee ID :

Designation: Salary Grade:

Department:

Type of Employment:

The following checklist is provided to assist employee and department with the exit process.

Date:

Others (please state)

Reason of Separation: Personal Ground

N/A

Clearance from Concerned Division ( )Please

tickReceiving initial with ID

Files & Company Documents Desk/Locker/Shelf/Keys/Uniform

Date:

Others (Please specify)

Store related stationeries, uniform/apron

Clearance from IT Division

Signature of Head of IT:

Charge handover

Receiving initial with ID

Signature with ID of Line Manager/Divisional

Head:

Please

tick

MR/15.06.2011 Page 1 of 6

7/29/2019 06-01-HR-F018

2/6

Form No: 06-01-HR-F018 Dhaka, Bangladesh.

Issue No:01

Employee Exit Clearance Form

Marketing total outstanding (taka): As on:

Motorcycle, Key & related documents:

Receiving initial with ID

Sig. of Depot/concerned In-charge:

Others (please state)

Date:Signature with ID of Line Manager/Divisional

Head:

Clearance from Human Resources DivisionPlease

tick

HR Comments / Remarks (if any)

Sig. Head of HR

Access/ID Card (returned)

Company Car & related document (Returned)

Others (please state)

I hereby accept responsibility for all the properties / benefits assigned to me during my employment. Upon my separation, in order to leave

The ACME Laboratories Ltd. in good standing and to clear all obligations, I agree that ACME has the authority to collect or deduct during

my exit procedure or from my final settlement any unpaid amounts for propert ies which are not returned, any overpayment of salary,

amounts due to the shortage of notice period or any other unpaid debts to the company.

Sig. of HR Manager/

HR Representative

Employee's Signature & Date

Signature of incumbent :

Signature of RSM/ASM/DSM/MM:

Outstanding Official Mobile Bill till last date of notice.

Receiving initial with ID

Advance Settled (if any)

Salary adjustment (due to Shortfall of Notice Period)

Mobile Number:

Exit Interview (done)

SIM Card [Mobile (returned/deactivated) & Mobile Set returned (if applicble)

Signature Line Manager :

Clearance from Accounts & Finance DivisionPlease

tick

Applicable for Marketing Sales Personnel & SPR only

MR/15.06.2011 Page 2 of 6

7/29/2019 06-01-HR-F018

3/6

Form No: Issue No:1

PC (Full set) /Lap Top/Printer/Scanner/Pen Drive:

Other accessories (if required, please specify):

Signature of Head of IT:

Charge handover

Others (Please specify)

Store related stationeries

Reason of Separation: Personal Ground

Date:

Date:Signature with ID of Line

Manager/Divisional Head:

Clearance from IT DivisionPlease

tickReceiving initial with ID

= Not ApplicableN/A

Others (please state)

Clearance from Concerned Division ( )Please

tickReceiving initial with ID

Files & Company Documents Desk/Locker/Safe/Keys/Uniform

Department: Division:

Confirmed

Date of Joining: Mobile Number:

Resignation submission Date: Resignation Effective Date:

ProbationType of Employment: Cotractual/Temporay

aSpecilized Pharmaceuticals Ltd

Corporate Office, Dhaka

Employee Name: Employee ID :

Employee Exit Clearance Form

Designation: Salary Grade:

Name of Sales Centre: Base Town:

(only applicable for sales & Depot personnel) (only applicable for sales personnel & SPR)

Casual

The following checklist is provided to assist employee and department with the exit process.

If required, also deactivate item. Kindly where task is completed and N/A when applicable.

= Task Completed

MR/HR/.....

7/29/2019 06-01-HR-F018

4/6

Form No: Issue No:1Employee Exit Clearance Form

Marketing total outstanding (taka): As on:

Motorcycle, Key & related documents:

Applicable for Marketing Sales Personnel & SPR only

Mobile Number:

Exit Interview (done)

SIM Card [Mobile (returned/deactivated) & Mobile Set returned (if applicble)

Sig. of Depot/concerned In-charge:

Sig. of HR Manager/

HR Representative

Signature Line Manager :

Signature of HOD:

Store related stationeries, uniform/apron

Signature of incumbent :

Signature of RSM/ASM/DSM/MM:

Outstanding Official Mobile Bill till last date of notice.

HR Comments / Remarks (if any)

Sig. Head of HR

Others (please state)

I hereby accept responsibility for all the properties / benefits assigned to me during my employment. Upon my separation, in order to leave

The ACME Laboratories Ltd. in good standing and to clear all obligations, I agree that ACME has the authority to co

Access/ID Card (returned)

Company Car & related document (Returned)

Employee's Signature & Date

Others (please state)

Date:Signature with ID of Line

Manager/Divisional Head:

Clearance from Human Resources Division(CO/Plant)Please

tickReceiving initial with ID

Advance Settled (if any)

Salary adjustment (due to Shortfall of Notice Period)

Clearance from Accounts & Finance DivisionPlease

tickReceiving initial with ID

MR/HR/.....

7/29/2019 06-01-HR-F018

5/6

Form No: Issue No:1

PC (Full set) /Lap Top/Printer/Scanner/Pen Drive:

Other accessories (if required, please specify):

Department:

Name of Sales Centre: Base Town:

Division:

Casual

aAgrovet & Beverage Ltd.

Corporate Office, Dhaka

Employee Name: Employee ID :

Employee Exit Clearance Form

(only applicable for Sales & Depot personnel) (only applicable for sales personnel & SPR)

Designation: Salary Grade:

Others (please state)

Clearance from Concerned Division ( )

Confirmed

Date of Joining: Mobile Number:

Resignation submission Date: Resignation Effective Date:

ProbationType of Employment: Cotractual/Temporay

Files & Company Documents Desk/Locker/Shelf/Keys/Uniform

Signature with ID of Line

Manager/Divisional Head:

The following checklist is provided to assist employee and department with the exit process.

If required, also deactivate item. Kindly where task is completed and N/A when applicable.

= Task Completed = Not ApplicableN/A

Date:

Please

tickReceiving initial with ID

Date:

Charge handover

Clearance from IT Division

Reason of Separation: Personal Ground

Signature of Head of IT:

Others (Please specify)

Store related stationeries, uniform/apron

Please

tickReceiving initial with ID

MR/HR/.....

7/29/2019 06-01-HR-F018

6/6

Form No: Issue No:1Employee Exit Clearance Form

Marketing total outstanding (taka): As on:

Motorcycle, Key & related documents:

Clearance from Accounts & Finance DivisionPlease

tickReceiving initial with ID

Sig. of Depot/concerned In-charge:

Access/ID Card (returned)

Company Car & related document (Returned)

Receiving initial with ID

Advance Settled (if any)

Salary adjustment (due to Shortfall of Notice Period)

Employee's Signature & Date

HR Comments / Remarks (if any)

Sig. Head of HR

Others (please state)

I hereby accept responsibility for all the properties / benefits assigned to me during my employment. Upon my separation, in order to leave

The ACME Laboratories Ltd. in good standing and to clear all obligations, I agree that ACME has the authority to co

Sig. of HR Manager/

HR Representative

Signature of incumbent :

Signature of RSM/ASM/DSM/MM:

Outstanding Official Mobile Bill till last date of notice.

Others (please state)

Date:

Applicable for Marketing Sales Personnel & SPR only

Mobile Number:

Exit Interview (done)

SIM Card [Mobile (returned/deactivated) & Mobile Set returned (if applicble)

Signature Line Manager :

Signature of HOD:

Signature with ID of Line

Manager/Divisional Head:

Clearance from Human Resources Division(CO/Plant)Please

tick

MR/HR/.....