No dues and Clearance Certificate from the Employee while leaving the company. Settlement will have to be made to the leaver only after obtaining this certificate duly approved by all concerned.

DOWNLOAD – No Dues – Clearance Certificate

COMPANY NAME
No Dues / Clearance Certificate
Name Employee Code
Unit\Department Reporting to
Date of Joining Date of Leaving
Please √
Dept. / Section Yes No Initials Remarks
Employee’s Department
• To handover files handled by him/her
• Soft/hard copies (list required)
• Floppies & CDs used
• Others
IT Section
• PC/Laptop
• Others
HR & Administration
• ID Card
• Health/Insurance Card
• Mobile Phone/Sim Card
• Keys for drawers, Cabinets, etc.,
• Books borrowed, if any
• Educational Declaration, if any
• Company Car (if any)
• Others
Payroll: Total Payment
• Final Settlement Benefits
• Any Loan Against salary
• Others
• Annual Leave Settlement
o Joining Date
o Resignation Date
o Leaves Till Resignation Date
o Utilized Leaves
o Balance Leaves

This is to certify that Mr./ Ms. …………………………….. has no outstanding dues as of ……………………….

Name/Department Signature Date Remarks
(employee name)
Supervisor / Department Head
Finance Manager
Administration Manager
Human Resources Manager
Managing Director

Note: –
.
• Settlement will have to be made to the leaver only after obtaining this certificate duly approved by all concerned.