| Name | |
|---|---|
| Employee number | |
| Department | |
| Last working day |
| Item | Cleared by | Date | Signature |
|---|---|---|---|
| Duties and files handed over | Supervisor | ||
| Laptop, phone and accessories | ICT | ||
| System accounts closed / transferred | ICT | ||
| ID card and keys | Administration | ||
| Uniform / PPE | Stores | ||
| Staff loan and advances | Finance | ||
| Imprest retired | Finance | ||
| Library / tools |
Final dues are paid once this form is complete. Amounts owed to the Employer are deducted from final dues only with the employee's written agreement or where the law allows.
Employee
Name, signature and date
HR
Name, signature and date