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Free form template · Word

IT Asset Clearance Form

An IT asset clearance form is the IT department's formal no-dues sign-off for a leaving employee, confirming that all IT devices are returned, accounts are disabled, data is handed over and licences are reclaimed. HR needs it before releasing full and final settlement and the relieving letter.

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  • Made for India
  • 22 fill-in fields highlighted
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Preview of the form

[Highlighted] = fill in
[Company Logo][Company Name]

IT ASSET CLEARANCE FORM

Clearance No.:
[Reference Number]
Date:
[Date]
Exit Ref. (HR):
[Exit Reference Number]

1. Employee Details

Employee Name[Employee Name]
Employee ID[Employee ID]
Designation[Designation]
Department[Department]
Reporting Manager[Reporting Manager]
Last Working Day[Last Working Day]

2. IT Assets

Asset IDAsset TypeMake / ModelSerial / IMEI No.ReturnedConditionReturn Form Ref.
[Asset ID]Laptop[Make / Model][Serial Number]Yes / No[Condition][Reference Number]
[Asset ID]Mobile phone[Make / Model][IMEI]Yes / No[Condition][Reference Number]
[Asset ID]Accessories (charger, mouse, headset)[Make / Model][Serial Number]Yes / No[Condition][Reference Number]
[Asset ID]Token / dongle / storage device[Make / Model][Serial Number]Yes / No[Condition][Reference Number]

3. Accounts and Access

Account / SystemStatusDate
Domain / directory loginDisabled[DD/MM/YYYY]
EmailBlocked / Forwarded / Shared mailbox[DD/MM/YYYY]
VPN / remote accessRevoked[DD/MM/YYYY]
Business applications ([Application Names])Revoked[DD/MM/YYYY]
Privileged / admin accessRevoked / Not applicable[DD/MM/YYYY]

4. Data and Licences

  • Work data handed over – confirmed by [Reporting Manager]
  • Ownership of shared files and repositories transferred
  • Software licences reclaimed: [Software Names]
  • Company data removed from personal devices – declared by employee

5. Pending Items and Recovery

ItemReasonAmount (₹)Action
[Item]Not returned / Damaged[Amount]Recover in F&F / Waived
[Item]Not returned / Damaged[Amount]Recover in F&F / Waived

6. Clearance Status

  • CLEARED – no IT dues
  • CLEARED WITH REMARKS – pending items listed above
  • NOT CLEARED – reason: [Reason]

Based on the above, the IT Department confirms the clearance status of [Employee Name] ([Employee ID]) as marked, for the purpose of full and final settlement.

Checked by
[IT Executive Name]
IT Department
Date: [Date]
Clearance issued by
[IT Head Name]
IT Head
Date: [Date]
Acknowledged by
[Employee Name]
Date: [Date]

What this template includes

  • Summary of IT assets returned with asset IDs
  • Account and access status at a glance
  • Data handover confirmation from the manager
  • Licences reclaimed
  • Pending items and any recovery amount
  • Clear status: cleared, cleared with remarks, or not cleared

When to use it

  • Final step of IT exit formalities before F&F
  • Transfer of an employee to another group entity with separate IT
  • End of a contractor's engagement with company devices
  • Audit evidence that IT clearance was given before relieving

How to customise this template

  1. 1Pull asset details from the laptop and mobile return forms
  2. 2Pull account status from the IT offboarding checklist
  3. 3Add your common business applications
  4. 4Name the IT authority who can issue clearance
  5. 5Copy the form to HR and payroll

HR tips

  • Issue clearance only after the data handover is confirmed by the manager
  • Use 'cleared with remarks' rather than blocking F&F for minor items
  • Quote amounts for any recovery so payroll can act
  • Keep the form with the employee's exit file

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Frequently asked questions

What is IT clearance at the time of resignation?+

It is IT's confirmation that the leaving employee has returned all IT assets and that their system access has been removed, so HR can proceed with F&F.

Can IT clearance be given with pending items?+

Yes, as 'cleared with remarks', listing the pending item and any recovery amount, if the company's process allows it.

Who signs the IT asset clearance form?+

The IT executive who handled the return, and the IT head or authorised person who issues the clearance. The employee also signs to acknowledge.