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MOH Clearance for Travel Form

The Full and Final Settlement Form is a document that employees must complete and submit to HR at least two days before their last employment date. It requires signatures from various departments to confirm the completion of tasks related to the employee's exit, including handover procedures, return of company property, and financial settlements. The form also addresses visa and insurance status, ensuring all necessary actions are taken before the employee's departure.

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Rajivpaul Pulidindi
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37 views2 pages

MOH Clearance for Travel Form

The Full and Final Settlement Form is a document that employees must complete and submit to HR at least two days before their last employment date. It requires signatures from various departments to confirm the completion of tasks related to the employee's exit, including handover procedures, return of company property, and financial settlements. The form also addresses visa and insurance status, ensuring all necessary actions are taken before the employee's departure.

Uploaded by

Rajivpaul Pulidindi
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Full and Final Settlement Form

Name of employee
Designation: Department:
Date of Joining: Date of Resignation:
Last date of employment E Code

It is the responsibility of the employee to ensure that this document is completed and submitted to the HR Department at least
two days before the last date of employment. Each of the sections has to be agreed and signed off by the concerned
department head. This document is to be attached to the financial settlement to enable the processing of the financial
settlement.

1. Line Manager
Signed by / Date
Job related handover completed Yes No
Handover notes prepared Yes No
Email access (official) Disable Delete Forward
If email to be forwarded, staff to forward to. *

*Mail box will be disabled after 1 month as per IT policy

2. Information Systems
Signed by / Date
Mailbox duplicated Yes No NA
Email access Disabled Deleted Forward
Change password for internet access Yes No NA
Data Back up Yes No NA

3. Finance & Accounts


Signed by / Date
Corporate Credit card returned Yes No NA
Credit card bills settled Yes No NA
Cash advances cleared Yes Final settlement NA
Cancel Signatory Status Yes No NA
Cancel retail outlet discount. Yes No NA
Center Level Advances

4. HR/ Administration

Signed by / Date
Mobile phone & SIM returned Yes No NA
Roaming service on phone cancelled? Yes No NA
Laptop returned Yes No NA
Leave Balance
Notice Period Required
Notice period waived Yes No
Notice Period Served
Comments
Visa / Insurance / Passport

Signed by / Date
Visa Status of employee** Cancel Transfer To be kept on hold
Visa Status of employee’s family Cancel Transfer To be kept on hold
If visa is on hold, when will it be cancelled
Visa cancelled on
Passport returned to staff Yes No NA
Medical insurance *** Cancel Keep valid NA
Medical insurance card returned Yes No NA
Medical Insurance cancelled on
If medical insurance to be kept valid, when will it
be cancelled
DHA / MOH / HAAD / OHC License Cancel Keep valid NA

Signed by / Date
Office access card returned Yes No NA
Parking card returned Yes No NA
Phone bill cleared Yes No NA
Air fare to be paid Yes No NA
Repatriation quotes received Yes No NA
Obtain forwarding address / phone no. Yes No NA
Remove from ‘payroll’ Yes No
Loans with bank Yes No
Final settlement to be sent to local bank Yes No
If final settlement to be sent to non-local bank,
details of Bank and Account No:
‘Exit Interview’ conducted Yes No
Resignation acceptance letter Yes No
Service certificate given Yes No
Others

Employee Name Employee Signature Date

Doc Ref no: VLCC/ HR /F&F Dt of issue: 26/1/2023 Rev no.01

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