Free form template · Word

Exit Clearance Form

An exit clearance form is the master sign-off sheet that a departing employee carries to each department before relieving. Every function confirms that nothing is pending against the employee, records any dues, and signs, after which HR releases the full and final settlement and relieving letter.

Editable Word (.docx)
Made for India
7 fill-in fields highlighted
Free, no sign-up

Download Word (.docx) — free

Preview of the form

[Highlighted] = fill in

[Company Logo][Company Name]

EXIT CLEARANCE FORM

Form No.:: [Reference Number]
Date Issued:: [Date]

Part A: Employee Details

Employee Name
Employee ID
Designation
Department
Work Location
Date of Joining
Date of Resignation / Separation
Last Working Day
Type of Separation (Resignation / Retirement / Termination / Contract End)

Part B: Departmental Clearance

Department	Items to Check	Dues / Recovery (₹)	Cleared By (Name)
Reporting Manager	Handover note, files, pending work	[Amount]	[Reporting Manager]
IT	Laptop, accessories, email and system access, software licences	[Amount]	[Name]
Admin	ID card, access card, locker key, parking sticker, mobile / SIM	[Amount]	[Name]
Finance / Accounts	Salary advance, loan, travel advance, expense claims, corporate card	[Amount]	[Name]
Stores / Library	Tools, uniforms, books, safety equipment	[Amount]	[Name]
HR	Exit interview, leave balance, insurance, PF and gratuity forms	[Amount]	[HR Name]

Part C: HR Final Clearance

Total Recoveries (₹)
Leave Balance for Encashment (days)
Notice Shortfall (days)
Exit Interview Completed On
F&F Released to Payroll On
Relieving Letter Issued On

Employee Declaration

I confirm that I have returned all company property and documents in my possession, handed over my work, and have no further claims other than my full and final settlement. I agree that the recoveries recorded above may be adjusted against my dues.

Employee
[Employee Name]
Date: [Date]

HR Manager
[HR Name]
Date: [Date]

Download Word (.docx) — free

What this template includes

Employee and separation details at the top
One row per clearing department with items to check
Dues or recoveries column with amount
Signature and date for each clearing authority
HR final clearance and F&F release
Employee declaration that nothing else is pending

When to use it

Any employee is leaving, whether by resignation, retirement or termination
You want one document that proves all departments have been cleared
Finance needs a list of recoveries before calculating F&F
Auditors ask for evidence of asset recovery from leavers

How to customise this template

1Add or remove departments to match your organisation (store, canteen, transport, library)
2Write the specific items each department checks in the second column
3Decide the sequence of sign-offs and number the rows accordingly
4Keep finance and HR as the last two signatures
5Convert it into a digital workflow if your HRMS supports it

HR tips

Start clearance at least a week before the last working day
Departments should note the exact amount of any dues, not just Not cleared
Do not hold earned salary indefinitely over minor pending items
Give the employee a copy of the completed form

For HR & hiring managers

Experienced and fresher candidates across India — blue, grey and white collar. Post a job in 5 minutes and start receiving applications.

Post a job free See plans

Post in 5 minutesDescribe the role in one line — we write the job description.
Verified applicantsEvery applicant has a verified mobile number.
Resume databaseSearch experienced candidates by skill, city and experience.

Frequently asked questions

Who issues the exit clearance form?+

HR issues it, usually when the resignation is accepted. The employee then gets it signed by each department and returns it to HR.

Is the exit clearance form required for full and final settlement?+

In most companies, yes. Finance uses it to confirm recoveries and HR uses it to release the settlement and relieving letter.

How is an exit clearance form different from a no-dues certificate?+

The clearance form is the working document with all department sign-offs. The no-dues certificate is the final summary issued once all departments have cleared the employee.

All 50 resignation, exit & full-and-final settlement →

[Company Logo][Company Name]

FINANCE EXIT CLEARANCE

Ref. No.:: [Reference Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Department
Last Working Day
PAN
Bank Account (last 4 digits)

Amounts Recoverable from Employee

Item	Reference	Outstanding (₹)
Salary advance	[Reference]	[Amount]
Personal / vehicle loan	[Reference]	[Amount]
Travel advance not settled	[Reference]	[Amount]
Cash imprest / petty cash	[Reference]	[Amount]
Corporate card unsettled charges	[Card last 4 digits]	[Amount]
Total recoverable		[Amount]

Amounts Payable to Employee

Form · Word

Finance Exit Clearance

Download .docx

[Company Logo][Company Name]

ADMINISTRATION EXIT CLEARANCE

Ref. No.:: [Reference Number]
Date:: [Date]

Employee Name
Employee ID
Department
Work Location
Last Working Day

Items and Facilities

Item / Facility	Issued (Yes / No)	Returned (Yes / No)	Recovery (₹)	Remarks
Employee ID card			[Amount]
Access / swipe card			[Amount]
Cabin, drawer and locker keys			[Amount]
Parking sticker / pass			[Amount]
Transport / shuttle pass			[Amount]
Canteen card / coupons			[Amount]
Company mobile / SIM (if admin-managed)			[Amount]
Stationery, visiting cards, uniform			[Amount]

Accommodation (if applicable)

Guest house / company flat address
Date of vacating
Inventory checked with employee (Yes / No)
Damages noted
Utility bills settled up to

Form · Word

Admin Exit Clearance

Download .docx

[Company Logo][Company Name]

DEPARTMENT CLEARANCE FORM

Department:: [Department]
Date:: [Date]

Employee Name
Employee ID
Designation
Head of Department
Successor / Interim Owner
Last Working Day

1. Work Handover

Activity / Responsibility	Status	Handed Over To
[Activity 1]	[Completed / Pending]	[Successor Name]
[Activity 2]	[Completed / Pending]	[Successor Name]
[Activity 3]	[Completed / Pending]	[Successor Name]

2. Records and Department Items

Department files and registers returned
Soft copies saved on shared drive
Samples, demo kits or instruments returned
Tools and equipment returned to section in-charge
Department stamp or seal returned, if held

Form · Word

Department Clearance Form

Download .docx

[Company Logo][Company Name]

ASSET CLEARANCE FORM

Ref. No.:: [Reference Number]
Date:: [Date]

Employee Name
Employee ID
Designation
Department
Work Location
Last Working Day

Assets Issued and Returned

S. No.	Asset Description	Asset Tag / Serial No.	Date Issued	Date Returned	Condition	Received By	Recovery (₹)
1	[Laptop]	[Tag No.]	[DD/MM/YYYY]	[DD/MM/YYYY]	[Good / Damaged / Missing]	[Name]	[Amount]
2	[Mobile phone]	[Tag No.]	[DD/MM/YYYY]	[DD/MM/YYYY]		[Name]	[Amount]
3	[Vehicle / two-wheeler]	[Registration No.]	[DD/MM/YYYY]	[DD/MM/YYYY]		[Name]	[Amount]
4	[Tools / sample kit]	[Tag No.]	[DD/MM/YYYY]	[DD/MM/YYYY]		[Name]	[Amount]
5	[Other]	[Tag No.]	[DD/MM/YYYY]	[DD/MM/YYYY]		[Name]	[Amount]

Total Recovery (₹)
Basis of recovery (Asset Policy clause)
Remarks

Declaration

Form · Word

Asset Clearance Form

Download .docx

[Company Logo][Company Name]
EXIT INTERVIEW FORM
Interview Date:
[Date]
Mode:
[In person / Video / Phone]
Interviewer:
[HR Name]
Employee Details
Employee Name
Employee ID
Designation
Department
Reporting Manager
Date of Joining
Last Working Day
Total Service (years / months)
Reasons for Leaving
Primary reason
Secondary reasons
When did you first think of leaving?
Was there anything that could have changed your decision?
Ratings (1 = Very poor, 5 = Excellent)
Form · Word
Employee Exit Interview Form
Download .docx
[Company Logo][Company Name]
EXIT FEEDBACK FORM
Department:
[Department]
Date:
[Date]
Dear colleague, thank you for your time with [Company Name]. Please spend ten minutes on this form. Your feedback is confidential and will not affect your settlement or relieving documents.
Name (optional)
Designation
Length of Service
Shift / Location
1. Main reasons for leaving (tick up to three)
- Salary
- Better job elsewhere
- Supervisor / manager
- Working hours or shifts
- Travel distance
- Workload
- Lack of growth
- Family or personal reasons
- Health
- Other: ____________
2. Please tick one option for each statement
Form · Word
Exit Interview Feedback Form
Download .docx
[Company Logo][Company Name]
EXIT REASON FORM
Record No.:
[Reference Number]
Date:
[Date]
Employee and Separation Details
Employee Name
Employee ID
Department
Grade / Level
Date of Joining
Last Working Day
Performance Rating (last cycle)
Separation Type (tick one)
- Voluntary – resignation
- Involuntary – termination for performance
- Involuntary – termination for misconduct
- Involuntary – retrenchment / role redundancy
- End of contract / non-renewal
- Retirement / superannuation
- Death or permanent disability
- Absconding / abandonment of service
Reason Codes
Form · Word
Exit Reason Form
Download .docx
[Company Logo][Company Name]
EMPLOYEE RESIGNATION FORM
Form No.:
[Reference Number]
Date Received by HR:
[Date]
[Company Name]
[Company Address]

To be filled by the employee and submitted to the reporting manager and HR. Please write clearly.
Section A: Employee Details
Employee Name
Employee ID
Designation
Department
Work Location
Date of Joining
Reporting Manager
UAN (for PF transfer)
Personal Email
Mobile Number
Section B: Resignation Details
Date of Resignation
Notice Period as per Appointment Letter
Requested Last Working Day
Request for Notice Waiver / Buyout (Yes / No)
If yes, reason for early release
Form · Word
Employee Resignation Form
Download .docx

Primary reason
Secondary reasons
When did you first think of leaving?
Was there anything that could have changed your decision?

Date of Resignation
Notice Period as per Appointment Letter
Requested Last Working Day
Request for Notice Waiver / Buyout (Yes / No)
If yes, reason for early release

Name (optional)
Designation
Length of Service
Shift / Location

Exit Clearance Form

Preview of the form

Part A: Employee Details

Part B: Departmental Clearance

Part C: HR Final Clearance

Employee Declaration

What this template includes

When to use it

How to customise this template

HR tips

Hire top talent from BetterJobs

Frequently asked questions

Related HR templates