FULL AND FINAL SETTLEMENT FORM

Name: Global ID:

Designation: Department:
DOJ: Business Email ID:
Resignation date: Relieving Date:

Stage – I: To be filled by the concerned departmental in charge

1. Supervisor / Team Leader

❑ All files/keys/documents returned ❑ All password protected files opened ❑ Assignments reallocated to: _______________________
Project Data in User’s Machine: ❑ Back-up required ❑ Transfer Data to: _________________________❑ Delete / Format the system
Client Offboarding Applicable ❑ Yes ❑ No If Yes; Client Offboarding Completed ❑ Yes ❑ No
Comments; if any ______________________________________________________________________________________________________
Name: ____________________________________ Signature: _____________________________________ Date: __________________
All official E-mails to be forwarded to the following id(s) for 30 days: __________________________________________________
2. Division Head: ______________________________________________________________________________________________________
Name: ____________________________________ Signature: _____________________________________ Date: __________________

Stage – II: FINANCE

Advances; if any ❑ Yes ❑ No if Yes; Amount to be recovered (in INR) ______________________________________

Remarks: _____________________________________________________________________________________________________________

Name: ____________________________________ Signature: _____________________________________ Date: __________________

Stage – III: SYSTEMS ADMINISTRATION

❑ PC Returned / Transferred to ___________________________ ❑ Laptop/Multimedia/CDs returned
❑ Computer at residence returned ❑ Internet / Domain Access Rights revoked
❑ VSS/Timesheet/VPN Client Login rights revoked ❑ ______________________ Login Revoked

Name: ____________________________________ Signature: _____________________________________ Date: __________________

Stage – IV: To be filled by Administration Dept

Received the following:

❑ Identity /Access Control Card ❑ Project related stationery ❑ Keys/Calculator ❑ Mobile Phone ❑ Vehicle
❑ Telephone/Fax at residence ❑ Library Books ❑ Food Deduction ____________________________________
❑ Travel/Courier clearance ❑ Guest House Deduction (if applicable) _________________ ❑ Workstation No. _____________
Any Others: ___________________________________________________________________________________________________________

Name: ____________________________________ Signature: _____________________________________ Date: __________________

Stage – V HUMAN RESOURCES

Earned Leave Balance (as on LWD) ______ Encashable Leave: ______
Total no. of days to be paid with FFS ______ Bonus Recoverable; if any: ______
Notice Period Served: ❑ Yes ❑ No Notice Pay Recoverable; if any: __ ___
Relocation Expenses Recoverable; if any: ______ Shift Allowance payable, if any: ______
Certification/Training cost Recoverable; if any: ______ IT Proofs Submitted: ❑ Yes ❑ No

Name: ____________________________________ Signature: _____________________________________ Date: __________________

Instructions by the Employee

Address for Correspondence: ____________________________________________________________________________________________

_____________________________________________________________________________________________________________________
E-mail ID: _________________________________________________ Contact Number: ____________________________________________

Note: Organization wide "Last Day" or "Goodbye" mails should not be sent.