Northline Analytics Private Limited
Plot No. 8, Phase 8-B, Industrial Area, S.A.S. Nagar (Mohali) 160055
EXIT CLEARANCE (NO-DUES) FORM
Date: 3 April 2026
Employee: Rajesh Bansal
Designation: Field Sales Executive
Employee ID: NA-0231
Date of joining: 1 April 2026
Last working day: 2 April 2026
Reporting manager: Harpreet Kaur, Sales Manager
A. WHAT THE EMPLOYEE IS TO RETURN
Identity card; office keys (2); laptop with charger; company mobile phone and SIM; visiting cards; field sales kit.
Accounts and systems to be closed: Company email, CRM login, shared drive, attendance app
Amount the employee is shown as owing to the Company: salary advance of Rs 15,000 as per the advance register
B. CLEARANCE BY EACH DEPARTMENT
- 1. Work and files handed over. Handover note received and work transferred.
Cleared / Not cleared. Remarks: ______________________
Signature, name and date: ______________________ (Reporting manager)
- 2. Property returned. Everything listed in part A has been returned in good order, or the shortfall is noted.
Cleared / Not cleared. Remarks: ______________________
Signature, name and date: ______________________ (Administration)
- 3. Systems and access. Email, logins and other access have been closed, and company data has been taken back.
Cleared / Not cleared. Remarks: ______________________
Signature, name and date: ______________________ (IT or the person responsible)
- 4. Accounts. Advances, loans and expense claims have been checked, and the amount outstanding, if any, is noted here: ______________________
Cleared / Not cleared. Remarks: ______________________
Signature, name and date: ______________________ (Accounts)
- 5. Human resources. Notice period, leave balance and records have been checked, and the final settlement has been started.
Cleared / Not cleared. Remarks: ______________________
Signature, name and date: ______________________ (Human Resources)
C. DECLARATION BY THE EMPLOYEE
I, Rajesh Bansal, confirm that I have handed over my work and returned all the Company property I held, as listed above, and that I have not kept any copy of the Company's confidential data. I have been told of any amount the Company says I owe, and I understand that my full and final settlement will be made separately. My signature here records only these facts and does not give up any right that the law gives me.
_________________________ Date: ___________________
Rajesh Bansal
Place: S.A.S. Nagar (Mohali)