EMPLOYEE CLEARANCE FORM Date:

Employee Information
Staff Name CATHERINE T. AVILA ID Number 1001160024
Job Title SALES STAFF - GMALL DAVAO Employment Start 01 OCT 2016
Project/Client COMIC ALLEY Employment End

The assignment of the above employee has been terminated and takes in PRINCIPAL/CLIENT CERTIFICATION
effect as per Employment End for the following reason/s This is to certify that the above employee has no obligations or liabilities as
of this date, unless otherwise being remarked below. We further release
 End of contract the said employee of any accountabilities with this department as certified
by the following signatories:
 Resignation Name Job Title Signature | Date

 Project completion

 Manpower reduction

 Terminated for cause

 Others

Remarks*
*Attached separate sheets if necessary

PG MANPOWER AGENCY
Total amount for
Item Description Deductible amount Reviewed by
release

ACCOUNTING DEPARTMENT

PRODUCTION/OPERATIONS

Noted by: EMPLOYEE CONFIRMATION

For and in consideration of the amount of Php. _______________ receipt of which is hereby
acknowledged, I hereby confirm that I have been cleared from any dues, therefore, shall not
claim further obligations in any manner from this agency.
_________________________________ (Sa pagtanggap ko po nang halagang nakalaan sa akin, kinukumpirma ko na ako ay wala nang
HR Department anumang pagkakautang at wala na ring maaaring balikan o hinging obligasyon mula sa
ahensyang ito.

_____________________________________
Signature over printed name | Date
PGMA-Employee Clearance Form/1116