Himalay College of Nursing
& Allied Health Sciences
EMPLOYEE CLEARANCE REPORT
Name
Designation
Department
I hereby undertake that I have returned all the HCN's material, documents, equipment, employee card,
overall etc., to which I had access during my period of employment and have cleared all dues towards
HCN. I further assure that if any liability on my part is discovered in future, I shall be responsible for that.
Employee Signature
Date
This is to certify that the above-mentioned employee has returned all the documents, equipment etc.
belonging to HCN and is hereby cleared of all dues as of the mentioned date.
S. N.
Section / Concern
1
Immediate Supervisor /
Coordinator
2
Library
3
IT In-Charge
4
Canteen
5
Office Manager
6
Human Resource
7
Finance
Principal
Remarks
Signature
Date
Date